Small Works Roster Registration - CVSD #356 | Central Valley School District

Business Contact Information

Company Name*

Answer required for "Company Name"

Company Website

Answer required for "Company Website"

Company Point of Contact Name*

Answer required for "Company Point of Contact Name"

Business Email*

Answer required for "Business Email"

Business Phone*

No Formatting, 10 digits

Number Required

Phone Ext:

Number Required

Company Address

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

Additional Business Information

Please upload most current W9*

Completed and Signed

Answer required for "Please upload most current W9"

Choose a file or drag it here.

Please upload your Certificate of Liability Insurance*

Minimum $1,000,000 Coverege

Answer required for "Please upload your Certificate of Liability Insurance"

Choose a file or drag it here.

What is your WA State Contractor' License Number:*

Answer required for "What is your WA State Contractor' License Number:"

What is your WA State Labor & Industries UBI#:*

Answer required for "What is your WA State Labor & Industries UBI#:"

How many Years have you been in business?*

Answer required for "How many Years have you been in business?"

How many employees do you employ?*

Answer required for "How many employees do you employ?"

Are you a Women, Veteran, or Minority Owned Business?*

Answer required for "Are you a Women, Veteran, or Minority Owned Business?"

Yes

Are you an Equal Opportunity Employer?*

Answer required for "Are you an Equal Opportunity Employer?"

Yes

Have you Performed Work for CVSD before?*

Answer required for "Have you Performed Work for CVSD before?"

Yes

What was the last CVSD Project Completed by your Firm?*

N/A if not applicable

Answer required for "What was the last CVSD Project Completed by your Firm?"

Please list any Purchasing Cooperatives and/or Interlocal Agreements your company is partnered with.*

N/A if not applicable

Answer required for "Please list any Purchasing Cooperatives and/or Interlocal Agreements your company is partnered with."

Project References

Reference #1

Company Name*

Answer required for "Company Name"

POC Name*

Answer required for "POC Name"

Phone*

Number Required

Email*

Answer required for "Email"

Reference #2

Company Name*

Answer required for "Company Name"

POC Name*

Answer required for "POC Name"

Phone*

Number Required

Email*

Answer required for "Email"

Reference #3

Company Name*

Answer required for "Company Name"

POC Name*

Answer required for "POC Name"

Phone*

Number Required

Email*

Answer required for "Email"

Please fix the highlighted areas below before submitting.

Small Works Roster Registration - CVSD #356