application for associate membership (specialty or subcontracor)
908 N. SECOND STREET/Harrisburg, PA 17102/ (717) 232-6071/ Fax (215) 568-3115
Harrisburg, PA 20
to:
Board of Directors
Gentlemen:
The following firm
of Street and number City,State,Zip FAX Number Phone Number
hereby makes application for associate (specialty or subcontractor) membership in your Association and, if accepted, agrees to abide by the Bylaws, rules and regulations thereof and all amendments thereto.
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:
Please list names and addresses of two or three General Contractors with whom your firm has worked.
The firm is a member of the following trade associations:
The following named individuals are authorized to represent the firm in all its relations with the Association:
nametitle nametitle
Is your firm a certified minority or women's business enterprise? (MBE/WBE)YesNo
If yes, by what agency(ies) has your firm been certified? (Please check)
The Minority Business Enterprise Council Pennsylvania Department of Transportation
The Minority Business Enterprise Council
Pennsylvania Department of Transportation
Other (please specify)
Very truly yours,
SPECIALTIES
Please check appropriate classifications: Maximum five please.
Asphalt
Block
Erector
Extrusions
Bumpers
Hauling
Fabrication & Erections
Construction
Rental
Erectors
Woodwork
Finishers
Millwork
Floor, Roof & Wall Systems
Formwork
Insulating
Placing
Precast & Prestressed
Pumping
All Types
Repair
Carpets
Preengineered
Prefabricated
Miscellaneous
(Blinds, Draperies, Shades, etc.)