Vendor Registration Form Organization Primary Contact Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email PhoneFaxBusiness Type Sole Proprietor Corporation Public Agency/Non-Profit Limited Partnership Minority Business Type (check all that apply): Minority-Owned (MBE) Woman-Owned (WBE) Small Business (SBA) Disabled-Veteran-Owned (SDVBE) Veteran Owned Disadvantaged Business (DBE) Very Small Business (VSBE) UCI Codes – Subcontractors (check all that apply): 000125 – Engineers 001126 – Consult 003113 – Prelim Sched 007319 – Health & Sfty 013100 – Mgmt. & Coor 013233 – Photo Doc 014500 – Quality Control 014523 – Test & Inspect 015213 – Field Office 015526 – Traffic Control 015713 – Temp Erosion & Sediment Control 017123.16 – Construction Survey 017413 – Progress Cleaning 017419 – Const. Waste Mgmt. & Disposal 022400 – Environmental Assessment 023200 – Geotechnical Investigations 024100 – Demolition 028100 – Transp & Disposal of HazMat 028200 – Asbestos Remediation 031113.16 – Concrete Shoring 033716 – Pumped Concrete 038000 – Concrete Cutting & Boring 040000 – Masonry 051000 – Structural Metal Framing 055000.1 – Misc. Metal Fabrications 071000 – Dampproofing & Waterproofing 093000 – Tiling 096000 – Flooring 099100 – Painting 110000.1 – Equipment Rentals 133400 – Fabricated Engineered Structures 134800 – Sound, Vibration & Seismic Cntrl. 230000 – Heating, Venting & Air Cond (HVAC) 260000 – Electrical 264200 – Cathodic Protection 310000 – Earthwork 311100 – Clearing & Grubbing 313200 – Soil Stabilization 314000 – Shoring & Underpinning 316200 – Driven Piles 320126.73 – Concrete and AC Milling 321216 – Asphalt Paving Business Category (check all that apply): Architect Association Attorney Construction Management Consultant Design Build Firm Developer Distributor Engineer Fabricator Financial General Contractor Graphic Arts Interior Design Manufacturer Marketing/Advertising Municipality Owner PR/Community Outreach Reprographer Sales Service Provider Subcontractor Supplier Surveyor Bondable: Yes No What is your aggregate bonding capacity: UCI Codes – Material Suppliers (check all that apply): 321313 – Concrete Paving 321613 – Curbs & Gutters 321623 – Sidewalks 321723 – Pavement Markings 323100 – Fences and Gates 323200 – Retaining Walls 323400 – Fabricated Bridges 331000 – Water Utilities 333000 – Sanitary Sewerage Utilities 334000 – Storm Drainage Utilities 341100 – Rail Tracks 344113 – Traffic Signals 731000 – Highway Const 731350 – Rebar Placement 731400 – Tunneling, Boring & Jacking 731500 – Trucking 731510 – Asphalt Milling 731550 – Pavement Perm Marking 731590 – Quality Assurance 731670 – Landscaping 031116.13 – Concrete Form Liners 032100 – Reinforcement Bars 034000 – Precast Concrete 050523 – Metal Fastenings 053100 – Steel Decking 055800.1 – Stainless Steel 073219 – Metal Roof Tiles 079500 – Expansion Control 104000 – Safety Specialties 107343 – Transportation Stop Shelters 108800 – Scales 129300 – Site Furnishings 132200 – Office Shelters & Booths 260000.1 – Electrical Suppliers 310519.26 – Geocomposites 313600 – Gabions 334216.13 – Catchbasins 731040 – Fence & Guard Rail 731110 – Driven Piles 731125 – H-Piles 731200 – Concrete Mtrls. 731310 – Architectural Precast Concrete Mtrls 731330 – Precast Box Culvert 731360 – Rebar Material 731560 – Signage 731580 – Electrical and Comm Structures 731610 – Pipe Culverts 731640 – Reinforced Concrete Pipe 731700 – Aggregate Materials Message Δ
