subcontractor form

Company Name

Owner Name

First

Last

Phone

Date

Address

Address Line 1

City

State

Zip Code

Do you Maintain General Liability Insurance?

What kind of service your company provides?

Do you maintain worker's comp insurance? (not required in the state of TX)

Reference 1 - Company Name

Reference 1 - Phone

Reference 1 - Project Type

Reference 2 - Company Name

Reference 2 - Phone

Reference 2 - Project Type

Reference 3 - Company Name

Reference 3 - Phone

Reference 3 - Project Type

Company Type

Company Website

Did your company change its name in the past 12 months?

If so, please state the previous name

Number of employees

What is your geographical area of service?

Is there any type of work that you would prefer to avoid?

Additional Information:

Number Project Website