38 Wall St., Benton Harbor, Michigan • 269-925-6100
Contractor Profile
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Company Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Mobile:
President/Owner Name:
Years in Business:
Total Employees:
Is your business minority-owned?
Is your business women-owned?
What Services/Goods does your company provide? (check all that apply)
Architectural Plumbing Flooring
Asphalt Paving/Coating Concrete      Wood/Tile Installation
Commercial Construction (new)      Block Work      Refinishing
Commercial Remodeling      Footings      Carpet Installation
Drywall      Foundations Residential Construction (new)
Demolition      Paving/Flatwork Residential Remodeling
Electrical      Removal Roofing
Grading/Excavation      Poured Walls Other
HVAC Painting Other
Landscaping Pest Control Other
Landscape Design Siding
Tree Removal Trucking
Licenses/Certifications (MBE, WBE, or Trade Certifications)
Licenses/Certifications:
Certifying Agency:
Business Reference 1:
Business Reference 2:
Union Affiliations:
Has your company ever been bonded?
What is your bonding capacity? $
Have you or your company
ever been denied bonding?
What is/was your largest job?
Has your company worked
on state/federal contracts?
Do you have
workers' compensation insurance?
Name of Insurance Company:
Do you own/rent/lease the following heavy equipment?
Equipment Own Rent Lease How Many? Capacity of Each:
Backhoe Loaders
Dozer
Dump Truck
Excavator
Grader
Shovel
Skid Steer Loader
Wheel End Loader
Other:
Other: