23 Equity Investments — Project Management

Contractor Registration

23 Equity Investments

Business & Contact

Legal Business NameTrade Name, if differentPrimary Contact NameEmailPhoneBusiness AddressCityStateZIP CodeTrade or SpecialtyYears in BusinessService AreaWebsite, optionalFederal Tax Classification

Licensing & Compliance

EIN or Tax IDLicense Number, when applicableLicense TypeLicense StateLicense Expiration DateInsurance ProviderInsurance Policy NumberInsurance Expiration DateEmergency ContactWorkers’ Compensation StatusW-9 Status

Supporting Documents

Attach applicable files. PDF, Word, Excel, JPG, and PNG files up to 10 MB are accepted.

W-9Certificate of InsuranceGeneral Liability InsuranceWorkers’ Compensation InsuranceBusiness LicenseTrade LicenseGovernment IDCertificationsReferencesPortfolio PhotosPrior Project DocumentsOther Supporting Documents

Account Security

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I certify that this application is complete and accurate, I am authorized to submit it, and I agree to maintain current licensing, insurance, tax, and payment information.