Firm Name (required)
Trade/Service (required)
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Estimating Point of Contact (required)
Phone (required)
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CT DAS Prequalifications (if applicable)
Federal Set Aside Designation Large BusinessSmall Disadvantage BusinessHUB Zone BusinessSDVOSBSmall Business8(a) Program ParticipantWoman-Owned Business
State of Connecticut Set Aside Designation WBESBEMBE
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Please attach SBE/MBE Certificate
Please attach list of last 5 significant projects with your contract amount.
Latest Experience Modification Rate
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Subject
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