ONLINE SUBCONTRACTOR BID LIST FORM

Subcontractors are requested to forward a current certificate of insurance stating limits of liability and workers compensation Experience Modification Rating to 540-896-6502. That certificate of insurance should cover General Liability, Auto and Workers Compensation.

Fields marked with an asterisk are required entries

*Company Name:

*VA/WV License #

*Contact Person:

 

*Mailing Address:

*City:

*State:

*Zip Code:

 

*Physical Address:

*City:

*State:

*Zip Code:

 
*Phone Number: - -
Fax Number: - -
 
*Email Address:
Web Address:
 

*Type of work interested in performing for us:
(e.g. drywall, plumbing, electrical, etc.)


(please use commas to seperate each entry)
 

*Areas that work is desired:
(West Virginia, Harrisonburg only, Route 81 corridor,
Page County, Shenandoah County, etc.)


(please use commas to seperate each entry)
 

*References:


(please use commas to seperate each entry)
 
 

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