Forte Construction and Design is looking to work with carpenter, painter, tile installer, plumber, electrician, cabinet installer, roof siding, concrete and asphalt subcontractors.

Please fill the form below if you are interested to work with us

Date:

COMPANY:

Company Name:

Address:

Phone Number:....Fax Number:

Contact Name:

Contact Email:

Type of company:

Date Formed:

Federal tax ID#:

LABOR:

Does the company have any union agreements? YesNo

MBE/WBE/SBE/DBE CERTIFICATION:

Is your firm certified? YesNo

If yes, please check all that apply:MBEWBESBEDBEDVBELSDBEOTHER

Certifying Agency (s):..............Certification Number (s)


BONDING CAPACITY:

Are you able to bond projects?: YesNo

Bonding Rate:

Single project limit:................................... Aggregate limit:

Bonding company address:........................... Agent name:

Agent phone number:

SAFETY:

Experience Modification Rate (EMR) for the past three years:

Current Year:

1st prior year:

2nd prior year:

Does the company have a written safety program and/or policies?YesNo
Does the company have a written drug policy?YesNo
Does the company employ a full-time safety professional?YesNo
In the last three years has the firm been cited for any serious (defined by OSHA) Violations?YesNo

INSURANCE:

Acknowledge you have the following minimum coverage: YesNo

Workers Compensation Insurance: Statutory Coverage in state where work is being done.
100,000 each accident
100,000 disease each employee
500,000 disease policy limit

General Liability:
1,000,000 each occurrence.
2,000,000 aggregate.
1,000,000 products and completed operations.

Auto:
1,000,000 any auto, hired and non owned.

Umbrella or Excess Liability:
1,000,000 each occurrence
1,000,000 aggregate

Insurance company address:

Agent Name:

Agent phone: