| For Help Call (301)-895-5161 |
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| Fields marked (*) are mandatory. |
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| Contractors Information |
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| Business Type Information | |
| Company Name | |
| Contact Name | |
| Email Address | |
| Company Address | |
| City | |
| State | |
| Zip | |
| Contractor's License # | |
| Phone | |
| Fax | |
| Type of Work | |
| Normal Geographic Area of Operation | |
| Years of Contracting Experience | |
| Business Net Worth ($) | |
| Largest Job Completed ($) | |
| Bid Bond / Final Bond Request Data |
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| For a BID BOND Only! |
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| What is the bid date? | |
| Bid % (if a flat amount give $ amount) | |
| Estimated total amount of bid ($) | |
| Anticipated Start Date | |
| Time for Completion | |
| Maintenance Period | |
| Liquidated Damages (LDs) ($) | |
| Obligee / Owner | |
| Obligee / Owner Address | |
| City | |
| State | |
| Zip | |
| Job Description | |
| How Much is Subcontracted? ($) | |
| Cost of Materials ($) | |
| For a FINAL BOND (Performance and/or Payment Bond) Only |
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| What is the contract date? (Date signed) | |
| Contract Price ($) | |
| Automated Start Date | |
| Time for Completion | |
| Maintenance Period | |
| Liquidated Damages (LDs) ($) | |
| Obligee / Owner | |
| Obligee / Owner Address | |
| City | |
| State | |
| Zip | |
| Job Description | |
| How Much is Subcontracted? ($) | |
| Cost of Materials ($) | |
| Next two lowest bidders |
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| if truly negotiated, check box | |
| 1. | |
| ($) | |
| 2. | |
| ($) | |
| INDEMNITORS (Provide the information below on all owners) |
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| Name (Owner #1) | |
| Address | |
| City | |
| State | |
| Zip | |
| % of Business Ownership | |
| What is your equity in real estate ($) | |
| Soc.Sec. # | |
| Date of Birth | |
| Spouse Name | |
| Spouse Net Worth | |
| Spouse Soc.Sec # | |
| Spouse Date of Birth | |
| Name (Owner #2) | |
| Address | |
| City | |
| State | |
| Zip | |
| % of Business Ownership | |
| What is your equity in real estate ($) | |
| Soc.Sec. # | |
| Date of Birth | |
| Spouse Name | |
| Spouse Net Worth | |
| Spouse Soc.Sec # | |
| Spouse Date of Birth | |
| Additional Comments |
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| Additional Comments | |