Legal Company Name *

Contact Person *

Address *

City *

State *

Zipcode *

Telephone *

Email Address *

Fax

Type of Business Professional Services Subscontractor Supplier Equipment Rental Trucking Administrative/Financial/Legal *

Type of work qualified to perform: (masonry, steel, etc.)

Specific Geographical Area You Work In: (Example: City & State)

Year Business Started *

Number of Employees

NAICS Codes (Separate each code with a comma) *

A California State Contractors License is required.

State *

Number *

Class (if applicable)

State

Number

Class (if applicable)

State

Number

Class (if applicable)

Federal Contracts / Small Business Administration Certification (check all that apply) HBCU/MI
HUB Zone SB
Large Business
SB
SDB8(a)
SDB
SD-VO
VOSB
WOSB
*

Minority Ownership (check all that apply) Not Minority Owned
DBE
DVBE
MBE
SBE
*

Prequalified with Metro? Yes No *

Certified DBE through the CUCP (California Unified Certification Program) Yes No *

CUCP Classification Number

CUCP Expiration Date

Craft Local Unions (List all that apply)

Annual Dollar Volume Your Firm Can Support *

Surety Name *

Surety Contact Person *

Surety Contact Telephone *

Bonding Capacity *

Insurance Company *

Insurance Contact Person *

Insurance Contact Telephone *

General Liability Insurance Carrier *

Liability Limits *

Safety - Current Experience Modification Rate *

Have you worked with our team members? Yes No *

Which team members? (check all that apply) Walsh Construction/Archer Western
J.F. Shea Company
HNTB Corporation
L. K. Comstock
ARUP

If yes, provide contract name, subcontract value, and date of completion