Company name *

Primary contact name *

Title / role

Phone Number *

Email Address *

Company website

Address

Street Address

City

State

Country

Enter your country

Postal Code

Trade and Service Information

Primary trade / service category *

Primary trade / service category

Describe your services

Service area *

Washington

Idaho

Other

Counties or cities served

Number of employees / typical crew size

Typical project size or scope

Current availability / lead time

Can you provide labor only, labor and materials, or both?

Licensing and Insurance

Washington contractor registration number

Idaho contractor registration or license number

License expiration date

General liability insurance carrier

General liability policy expiration date

Workers’ compensation coverage status

Bonding capacity, if applicable

Can you provide a current Certificate of Insurance?

Experience and References

Years in business

Recent custom-home or comparable-project experience

Project portfolio, website, or photo-gallery link

Reference 1: company/contact name, phone, and email

Reference 2: company/contact name, phone, and email

Additional comments or information

Documents

Certificate of Insurance

W-9

Contractor license or registration

Portfolio, resume, qualifications package, or reference sheet

I certify that the information submitted is accurate. I understand that submission of this form does not create a subcontract agreement, guarantee bidding opportunities, or guarantee work with Elk Run Homes.