SubContractors Entry Form

SubContractors Entry Form

Company Name*

Company Address*

City

State/Province*

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Billing Zip/Postal Code

Division/Trade*

(please select all that apply)

Select

What states does your business operate/service?

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Email*

Preferred Name

Phone*

Phone

Union?*

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Diverse Vendor Program

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License Number

Are you interested in bidding future Prime jobs?

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Do you currently have an active Workers Comp Policy?*

Prime Retail Services requires all vendors/subcontractors to have/maintain workers comp policy

Select

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