AGC of Pennsylvania - Affiliate Membership Application

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ABOUT AGC OF PA

MEMBER ACCOUNT

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application for affiliate membership
908 N. SECOND STREET/Harrisburg, PA 17102/ (717) 232-6071/
Fax (215) 568-3115

Harrisburg, PA 20

to:

Board of Directors
Associated General Contractors of Pennsylvania, Inc.
908 N. Second Street
Harrisburg, PA 17102

Gentlemen:

The following firm

of
Street and number City,State,Zip FAX Number Phone Number

hereby makes application for Affiliate membership in your Association and, if accepted, agrees to abide by the Bylaws, rules and regulations thereof and all amendments thereto.

The undersigned further agrees, if accepted, to pay all costs of membership from the date of acceptance of this application to the effective date of its resignation, as prescribed in the Bylaws, including, but not by way of limitation, membership dues, assessments, and other charges imposed at any time, and authorizes and empowers the Association to collect said costs of membership by legal process, if necessary, in the event of a default in the payment thereof.

This firm is incorporated under the laws of the State of
individually owned business partnership

This firm has been engaged in the construction business since
19

Business specialty for listing in Association Roster

The firm is a member of the following trade associations:

The following firms are given as reference:

Very truly yours,

full name of firm

signature and position

Is your firm a certified minority or women's business enterprise? (MBE/WBE)Yes
No

If yes, by what agency(ies) has your firm been certified? (Please check)

The Minority Business Enterprise Council

Pennsylvania Department of Transportation

Other
(please specify)

Please check appropriate classifications: (Maximum of 5)

Accounting & Auditing	Advice In Corporate Liability	Alarm Services
Architectural Hardware	Association	Attorney
Back Injury Prevention	Banking	Black Top Supplier
Blinds	Brick Products	Builders Hardware
Building Cleaning	Building Materials & Supplier	Carpets
Casework	Central Mix Concrete	Civil Engineer
Claims Preparation	Communications	Computer Construction Software
Computer Services & Supplies	Concrete Supplier & Accessories	Construction Clean Up
Construction Computer Systems	Construction Consulting	Construction Engineering & Surveying Supplies
Construction Products	Construction Recruiting	Construction Reporting Service
Construction Video	Consultants	Consulting Engineers
Crane Rental	Distributor of Materials Handling Equipment	Doors-Supplier (All Types)
Education	Employee Benefits	Environmental Consultant
Fire Protection Equipment	Geotextiles	Greenhouses & Glass Enclosures
Hardware	Industrial Hygiene Surveys	Insurance
Insurance Consultants	Land Surveyors	Lumber & Millwork Suppliers
Management Consultants	Marketing Consultants	Metal-Ornamental
Paints & Painting Equipment	Permit & Code Consulting	Radio Communication & Closed Circuit TV. Equipment
Redevelopment of Real Estate	Safety Equipment	Safety Inspections
Sand & Stone	Security Guard Services	Security Systems
Storage Trailers	Surveyor & Surveying Supplies	Tools
Trash Removal	Variety Chain Store	Washroom Accessories
Zoning	Other:

Fax completed form to Jud Vogdes, 215-568-3115.

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