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SUPPLIER
Pre-Qualification Form
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I. Business Section
Date
*
+
Project, If Applicable
Supplier Name
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip/Postal Code
*
County
*
Phone Number
*
Fax Number
*
Supplier Website
*
Contact Name
*
Contact Title
*
Contact Email
*
Type of Supplier
*
Manufacturer
Retail / Distributor
Distributor / Subcontractor
Retail
Other
Other
Type of Business
*
Corporation
Sole Proprietor
Partnership
LLC/LLP
Other
Other
Federal Tax ID
*
Years in Business
*
Up to three years
Three to five years
Five to ten years
More than ten years
Number of Employees
*
Up to 19
20 to 99
100 to 499
Over 500
Have you failed to complete awarded work or been terminated for a cause? (If yes, please explain)
*
No
Yes
Yes
Is your company directly or indirectly signatory to any labor union agreements?
*
No
Yes
Have any of the company officers ever done business with AHS or its entities through another company?
*
No
Yes
How many Multi-Family projects have you done in the last five years?
*
No
Just one project
Up to three projects
More than three projects