Overview
*Company Name:
*Company Address:
*Company Type: CorporationPartnershipIndividualJoint VentureOther
*Type of Work:
*How many years has your organization been in business as a contractor?
*How many years has your organization been in business under its current business name?
Under what other name(s) has your organization formerly operated under?
EIN# (Tax ID or SSN):
*Is your company e-verified? If not, please do so HERE. YesNo
Date of Establishment:
State where Established: —Please choose an option—ALAKAZARCACOCTFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYOther
Contact Information
*Contact Name:
*Contact Email:
*Contact Phone:
President's Name:
Vice-President's Name:
Secretary's Name:
Name of General Partner if Partnership:
Owner Name if different from President:
Experience
List the categories of work that your organization normally performs with its town forces:
List three trade references:
1. Project Name & Contact Info:
2. Project Name & Contact Info:
3. Project Name & Contact Info:
Capabilities Statement (pdf, jpg, jpeg, docx, doc, png):
History of Past Performance (pdf, jpg, jpeg, docx, doc, png):
Claims & Suits
If your answer to any of the questions below is yes, please provide details.
Has your organization ever failed to complete any work awarded to it?
Are there any judgements, claims, arbitration proceedings, or suits pending or outstanding against your organization and/or its officers?
Has your organization filed any lawsuits or requested arbitration with regards to construction contracts within the last five years?
File Upload
Acceptable file types: pdf, jpg, jpeg, doc, docx, png
Attach the current year's W-9 Form:
BUSINESS LICENSING
List jurisdictions and trade categories in which your organization is legally qualified to do business, and indicate registration or license numbers, if applicable:
License Expiration Date:
Attach Business Licensing:
SURETY
Name of Bonding Company:
Attach Surety:
INSURANCE
Please ensure IPS is listed as the certificate holder: Innovative Project Solutions, Inc. 50 California St, 15th Floor San Francisco, CA 94111
Please see additional COI requirements here.
Name of Insurance Company:
Insurance Expiration Date:
Workers Compensation Expiration Date:
Attach Insurance:
Submission
Optional Additional Notes / Remit Address (if different from Company Address):
*I hereby certify to the best of my knowledge that the information provided herein is true and sufficiently complete so as not to be misleading.
