Please mail
completed form to
MRCA 120 E Main Sidney MT 59270
| DATE____________________________________________________________________________________ |
| COMPANY NAME_________________________________________________________________________ |
| VOTING REPRESENTATIVE_________________________________________________________________ |
| TITLE ___________________________________________________________________________________ |
| MAILING
ADDRESS________________________________________________________________________ _________________________________________________________________________________________ |
| STREET ADDRESS_______________________________________________________________________ |
| TELEPHONE ____________________________________________________________________________ |
| MONTANA CONTRACTOR'S LICENSE NUMBER _______________________________________________ |
| BUSINESS ORGANIZATION | CORPORATION | PARTNERSHIP | SOLE PROPRIETORSHIP |
| COMMERCIAL | INDUSTRIAL | RESIDENTIAL | BUILT-UP | SLATE/TILE |
| SHINGLES | MODIFIED | RUBBER | PVC | METAL ROOFING |
| WATERPROOFING | PUF | Other______________________________________ | ||
| ANNUAL VOLUME OF COMPANY IN ROOFING AND ROOFING SHEET METAL ONLY |
0 TO 100,000 | 100,000 TO 500,000 |
| 500,000 TO 1 MILLION | 1 MILL TO 2 MILL | |
| 2 MILL TO 3 MILL | OVER 3 MILLION |
| HOW MANY YEARS IN BUSINESS UNDER THIS NAME ____ | |||||
| YEARS UNDER SOME FORMER NAME_____ | |||||
FORMER NAME _____________________________________________________ |
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|
TOTAL EMPLOYEES DURING SLOW PERIOD_________ |
DURING PEAK PERIOD__________ |
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|
OTHER BUSINESS DONE UNDER SAME COMPANY NAME |
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|
MECHANICAL |
SHEET METAL | GENERAL CONTRACTING | PLUMBING | ||
|
PAINTING |
ELECTRICAL | OTHER_______________________________________________ | |||