BIS Construction and Ship Services : : : Construction | Ship Cleaning

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Company Name * Address * Address * City * State * Zip * Phone * Fax Contact Name * Cell Phone * Email * Federal ID#

Business Statuts | check all that apply

Small Disadvantage Busienss HUBZone Small Business Veteran Small Business Woman Owned Business Small Business Service Disabled Veteran Large Business

Equipment Fleet | Please specify quantity

Prentice/Self Loader Haul Trailers Dump Trucks Bobcat/Skid Steer Loaders Wheel Loader Dozers Excavators Rubber Tire Loaders Roll-Off Boxes

Additional Equipment | check all that apply

Are your employees leased, direct hire, or both?

Number of Employees Years in Business D&B Number

Insurance Info

General Liability $1,000,000 each Occurrence General Liability Aggregate $2,000,000 Auto Liability $1,000,000 * Workers Comp Statutory Drop Box

Additional Info or Comments