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Note: * Required Information
   General Information
*Legal Business Name: *Doing Business As:
Areas of Business (separate multiple by ';'): Corporate Website:
Insurance Cert #: Contractor License #:
*Address Line 1: Address Line 2:
*City: *State:
*Zip:
*Office Phone: Fax:
Number of Employees: *Contractual Capacity:
*Business Start Date:
*Description of Business: * Note: This is limited to 600 characters
   Point of Contact   
*Name: *Email:
*Phone: Fax:
   Owner Information
*Principal's Name: *Email Address:
*Phone: Fax:
Title: *Percent Owner:
Principal's Name #2: Email Address:
Phone: Fax:
Title: Percent Owner:
*Who owns the controlling interest in your firm?
   Business Type
*W/MBE Certifications: Note: If you are certified through the MnUCP program; your certification is a DBE
CERT WBE   
CERT MBE   
CERT SBE   
DBE   
TGB   
VOSB   
SDVOSB   
NCMSDC   
WBENC   
NOT CERTIFIED
   *Products and Services (select up to 3)
   Union Affliation
Is your firm signatory to a Union?:
   Non Union Affiliated Firms
Willing to enter into an exclusive Project Labor Agreement?
   If your company has a logo, upload it here(.png, .jpg, or .gif smaller than 500kb)
Logo[Not Uploaded]:


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