Contractor Application - PENNSYLVANIA - MOBILE

PAGE 1 - FIRM INFORMATION AND QUALIFICATIONS

GENERAL INFORMATION







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OWNERSHIP INFORMATION - Complete the following for each owner of the firm









TRADE LICENSES - List any trade licenses of lead certifications











PAGE 2 - COMPANY SERVICES & DESIRED LOCATIONS



Where is your firm interested in working?

Additional requirements for the Lehigh County Program

1) Contractors must be current on taxes owed to Lehigh County at time of bid award. The Program will deem the bid as non-responsible for any business owner owning any parcel which is listed as delinquent in Lehigh County’s tax delinquency database. Tax payment plans are acceptable, but must be approved by Lehigh County prior to bid award.

2) Contractors must have a business office with a Pennsylvania mailing address

PAGE 3 - REFERENCES


Please provide five (5) references for projects completed in the last two (2) years in Pennsylvania.
REFERENCE #1





REFERENCE #2





REFERENCE #3





REFERENCE #4





REFERENCE #5






Please provide the name and municipality of at least two (2) code officials who recently inspected your work in Pennsylvania.
CODE OFFICIAL #1





CODE OFFICIAL #2






Have you ever worked in any other housing rehabilitation or government-funded programs?  

PAGE 4 - REQUIRED DOCUMENTS

PLEASE NOTE: You can upload required documents directly to this application using in the "UPLOAD REQUIRED DOCUMENTS" section.  If you do not wish to submit these documents using this upload feature, please see below for instructions on how to send via mail, email, or fax.

All requested documents MUST be submitted prior to award of your first contract!

UPLOAD REQUIRED DOCUMENTS




SUBMITTING REQUIRED DOCUMENTATION VIA MAIL, EMAIL, OR FAX
If you wish to submit the required documentation through the mail, by email, or by fax, please download the documentation checklist here:


Mail, Email, or Fax your required documentation to:

Attn: Housing Rehabilitation

Community Grants, Planning & Housing

101 Interchange Plaza Suite 301

Cranbury, NJ 08512

Phone: (609) 664-2783

Email: contractorswanted@cgph.net

Fax: (609) 664-2786

PAGE 5 - SUBMISSION


Please review all of the information you have entered by using the "Previous Page" and "Next Page" buttons to navigate through this application form.

As a reminder, you must submit all required documentation before your first contract!


Signature:

I certify that the information provided herein is true and complete and that any misrepresentation herein may be cause for disqualification. I also understand that this information is to be used only for determining my preliminary eligibility and does not obligate me in any way.


 

You will receive notification that your application was successfully submitted.   If you do not receive this notification, please resubmit your application.


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