E-Contractor Application Form

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Date*

Are You The Business Owner?*

First Name*

Last Name*

Job Title*

Company*

Address 1*

Address 2

City*

State*

Zip Code*

Phone Number*

Fax Number

Email Address*

Website

SECTION II: SMALL/MINORITY CONTRACTOR BUSINESS INFORMATION

Business Type*

Union Contractor*

Date Business Established*

Contractor’s License Number*

Class*

EIN*

Federal Tax ID Number*

Number Of Employees*

Primary North American Industrial Classification System Code (NAICS)*
You can determine your NAICS code on the SBA Website here.

Other NAICS Code(s), if applicable

General Contractors: Annual Revenue*

Specialty Trades: Annual Revenue*

Certified Small Business Enterprise (SBE)*

Certifying Agency, if yes

Certified Minority-Owned Business Enterprise (MBE)*

Certifying Agency, if yes

Government Public Works Project Experience*

Assigning Agency, if yes

SECTION III: SMALL/MINORITY CONTRACTOR STATISTICAL INFORMATION

Gender*

Ethnicity*

Household Income*

Military Status*

Contact

For more information about E-Contractor Academy, contact:

Northern California: Avni Jamdar
Southern California: Wendy Angel
Northwest: Steve Gelb
Northeast: Daryl Wright

Submit your message below.

Testimonials

Ryan Tittsworth

President RBT Electric Inc., Los Angeles

“[The E-Contractor Academy] was a great way to increase our capacity and learn practical techniques about how to improve our business and compete for larger contracts.”