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Company Name

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City

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Title

Firm Address

City

State Choose a state Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon

Zip

Office Phone

Office Fax

Email

Website Address

Year Firm Began

Number of Employees

Alternate Contact

Phone

Email

What Services Does Your Company Perform?
(Check all that apply)

CM/Program Management

GC

Self Perform

Main Divisions 23 Construction 236115 New Single-Family Housing Construction (except Operative Builders) 236116 New Multifamily Housing Construction (except Operative Builders) 236117 New Housing Operative Builders 236118 Residential Remodelers 236210 Industrial Building Construction 236220 Commercial and Institutional Building Construction 237110 Water and Sewer Line and Related Structures Construction 237120 Oil and Gas Pipeline and Related Structures Construction 237130 Power and Communication Line and Related Structures Construction 237210 Land Subdivision 237310 Highway - Street - and Bridge Construction 237990 Other Heavy and Civil Engineering Construction 238110 Poured Concrete Foundation and Structure Contractors 238120 Structural Steel and Precast Concrete Contractors 238130 Framing Contractors 238140 Masonry Contractors 238150 Glass and Glazing Contractors 238160 Roofing Contractors 238170 Siding Contractors 238190 Other Foundation- Structure-and Building Exterior Contractors 238210 Electrical Contractors 238220 Plumbing- Heating - and Air-Conditioning Contractors 238290 Other Building Equipment Contractors 238310 Drywall and Insulation Contractors 238320 Painting and Wall Covering Contractors 238330 Flooring Contractors 238340 Tile and Terrazzo Contractors 238350 Finish Carpentry Contractors 238390 Other Building Finishing Contractors 238910 Site Preparation Contractors 238990 All Other Specialty Trade Contractors

Divisions 23 Construction 236115 New Single-Family Housing Construction (except Operative Builders) 236116 New Multifamily Housing Construction (except Operative Builders) 236117 New Housing Operative Builders 236118 Residential Remodelers 236210 Industrial Building Construction 236220 Commercial and Institutional Building Construction 237110 Water and Sewer Line and Related Structures Construction 237120 Oil and Gas Pipeline and Related Structures Construction 237130 Power and Communication Line and Related Structures Construction 237210 Land Subdivision 237310 Highway - Street - and Bridge Construction 237990 Other Heavy and Civil Engineering Construction 238110 Poured Concrete Foundation and Structure Contractors 238120 Structural Steel and Precast Concrete Contractors 238130 Framing Contractors 238140 Masonry Contractors 238150 Glass and Glazing Contractors 238160 Roofing Contractors 238170 Siding Contractors 238190 Other Foundation- Structure-and Building Exterior Contractors 238210 Electrical Contractors 238220 Plumbing- Heating - and Air-Conditioning Contractors 238290 Other Building Equipment Contractors 238310 Drywall and Insulation Contractors 238320 Painting and Wall Covering Contractors 238330 Flooring Contractors 238340 Tile and Terrazzo Contractors 238350 Finish Carpentry Contractors 238390 Other Building Finishing Contractors 238910 Site Preparation Contractors 238990 All Other Specialty Trade Contractors

Divisions 23 Construction 236115 New Single-Family Housing Construction (except Operative Builders) 236116 New Multifamily Housing Construction (except Operative Builders) 236117 New Housing Operative Builders 236118 Residential Remodelers 236210 Industrial Building Construction 236220 Commercial and Institutional Building Construction 237110 Water and Sewer Line and Related Structures Construction 237120 Oil and Gas Pipeline and Related Structures Construction 237130 Power and Communication Line and Related Structures Construction 237210 Land Subdivision 237310 Highway - Street - and Bridge Construction 237990 Other Heavy and Civil Engineering Construction 238110 Poured Concrete Foundation and Structure Contractors 238120 Structural Steel and Precast Concrete Contractors 238130 Framing Contractors 238140 Masonry Contractors 238150 Glass and Glazing Contractors 238160 Roofing Contractors 238170 Siding Contractors 238190 Other Foundation- Structure-and Building Exterior Contractors 238210 Electrical Contractors 238220 Plumbing- Heating - and Air-Conditioning Contractors 238290 Other Building Equipment Contractors 238310 Drywall and Insulation Contractors 238320 Painting and Wall Covering Contractors 238330 Flooring Contractors 238340 Tile and Terrazzo Contractors 238350 Finish Carpentry Contractors 238390 Other Building Finishing Contractors 238910 Site Preparation Contractors 238990 All Other Specialty Trade Contractors

Divisions 23 Construction 236115 New Single-Family Housing Construction (except Operative Builders) 236116 New Multifamily Housing Construction (except Operative Builders) 236117 New Housing Operative Builders 236118 Residential Remodelers 236210 Industrial Building Construction 236220 Commercial and Institutional Building Construction 237110 Water and Sewer Line and Related Structures Construction 237120 Oil and Gas Pipeline and Related Structures Construction 237130 Power and Communication Line and Related Structures Construction 237210 Land Subdivision 237310 Highway - Street - and Bridge Construction 237990 Other Heavy and Civil Engineering Construction 238110 Poured Concrete Foundation and Structure Contractors 238120 Structural Steel and Precast Concrete Contractors 238130 Framing Contractors 238140 Masonry Contractors 238150 Glass and Glazing Contractors 238160 Roofing Contractors 238170 Siding Contractors 238190 Other Foundation- Structure-and Building Exterior Contractors 238210 Electrical Contractors 238220 Plumbing- Heating - and Air-Conditioning Contractors 238290 Other Building Equipment Contractors 238310 Drywall and Insulation Contractors 238320 Painting and Wall Covering Contractors 238330 Flooring Contractors 238340 Tile and Terrazzo Contractors 238350 Finish Carpentry Contractors 238390 Other Building Finishing Contractors 238910 Site Preparation Contractors 238990 All Other Specialty Trade Contractors

Divisions 23 Construction 236115 New Single-Family Housing Construction (except Operative Builders) 236116 New Multifamily Housing Construction (except Operative Builders) 236117 New Housing Operative Builders 236118 Residential Remodelers 236210 Industrial Building Construction 236220 Commercial and Institutional Building Construction 237110 Water and Sewer Line and Related Structures Construction 237120 Oil and Gas Pipeline and Related Structures Construction 237130 Power and Communication Line and Related Structures Construction 237210 Land Subdivision 237310 Highway - Street - and Bridge Construction 237990 Other Heavy and Civil Engineering Construction 238110 Poured Concrete Foundation and Structure Contractors 238120 Structural Steel and Precast Concrete Contractors 238130 Framing Contractors 238140 Masonry Contractors 238150 Glass and Glazing Contractors 238160 Roofing Contractors 238170 Siding Contractors 238190 Other Foundation- Structure-and Building Exterior Contractors 238210 Electrical Contractors 238220 Plumbing- Heating - and Air-Conditioning Contractors 238290 Other Building Equipment Contractors 238310 Drywall and Insulation Contractors 238320 Painting and Wall Covering Contractors 238330 Flooring Contractors 238340 Tile and Terrazzo Contractors 238350 Finish Carpentry Contractors 238390 Other Building Finishing Contractors 238910 Site Preparation Contractors 238990 All Other Specialty Trade Contractors

Divisions 23 Construction 236115 New Single-Family Housing Construction (except Operative Builders) 236116 New Multifamily Housing Construction (except Operative Builders) 236117 New Housing Operative Builders 236118 Residential Remodelers 236210 Industrial Building Construction 236220 Commercial and Institutional Building Construction 237110 Water and Sewer Line and Related Structures Construction 237120 Oil and Gas Pipeline and Related Structures Construction 237130 Power and Communication Line and Related Structures Construction 237210 Land Subdivision 237310 Highway - Street - and Bridge Construction 237990 Other Heavy and Civil Engineering Construction 238110 Poured Concrete Foundation and Structure Contractors 238120 Structural Steel and Precast Concrete Contractors 238130 Framing Contractors 238140 Masonry Contractors 238150 Glass and Glazing Contractors 238160 Roofing Contractors 238170 Siding Contractors 238190 Other Foundation- Structure-and Building Exterior Contractors 238210 Electrical Contractors 238220 Plumbing- Heating - and Air-Conditioning Contractors 238290 Other Building Equipment Contractors 238310 Drywall and Insulation Contractors 238320 Painting and Wall Covering Contractors 238330 Flooring Contractors 238340 Tile and Terrazzo Contractors 238350 Finish Carpentry Contractors 238390 Other Building Finishing Contractors 238910 Site Preparation Contractors 238990 All Other Specialty Trade Contractors

Does Your State Require A License For Each
Division You Selected/Perform?

Pick One Yes No

Other/Non Construction Or Industry-Related Service

Please put info Other related industry

Please Identify Your Firms Maximum Insurance Limits

General Liability Amount under $1m over $1m under $250k over $250k

Workmans Comp Amount under $1m over $1m under $250k over $250k

Umbrella Amount under $1m over $1m under $250k over $250k

Builders Risk Amount under $1m over $1m under $250k over $250k

Auto Amount under $1m over $1m under $250k over $250k

Is your company bonded?

PIck One Pick One Yes No

If yes, what is its bonding capacity? Bonding Capacity less than $25,000 $25,000 - $100,000 $100,000 - $250,000 $250,000 - $500,000 $500,000 - $1,000,000 over $1,000,000

Company Licenses, Professional Credentials and Industry Certifications (check all that apply):

GC

CM

Residential

Not Required in State

Other

OSHA

EPA

NCCER

LEED

Green Advantage

Other

M/DBE

Define Status Define Status African American Hispanic American Indian Alaskan Native Asian American Pacific Islander WBE SBE DBE 8A Disabled Vet Hub Zone Other

Within Which Sector(s) Does Your Firm Work
(check all that apply):

Public /Governmental

Private

Commercial

Residential

Educational

Heavy/Highway

Hospitality

Institutional/Cultural

Medical

Other

Is Your Firm Affiliated with Any Unions: Pick One Yes No

Chapter you wish to attend: Atlanta Detroit Houston (TX) Jacksonville (NE Fl) Los Angeles (S CA) Las Vegas (NV) Mid California (M CA) North Carolina (NC) Northern California (N CA) Ohio (OH) Philadelphia (PA) Portland (OR) Upper Mid West (MN / IA / ND / SD) Washington (DC) Washington (WA) West Palm Beach (S FL) Wisconsin (WI) National Office of NAMC South Carolina New York San Diego & Imperial County Chapter

Committee interested in: Education/Training Procurement/Business Opportunities Legislative/Advocacy Finance/Budget Nominating Corporate Partners/Sponsorships Membership/Chapter Development Mentor/Protege

Which Additional (Industry-Related) Affiliations Do You Hold with Nationally Recognized Organizations?

AGC

ABC

COMTO

AMAC

WCOE

Other

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