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SUBCONTRACTOR PRE-QUALIFICATION
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*Date:
*Contractor Name:
*Contractor Address:
*City:   *State:   *Zip:
Phone:
Email:
*NOTE: Enter a telephone number and/or an email address; both are not required.
*Type of Work Performed:
*Geographical Preference for Subcontracted Work:
*Minority Certification Number:
*State Where Certified:
*Agency Certifying Subcontractor:
*Are you a HUB supplier?


*Dun and Bradstreet Number:
Financial Institution Reference:
*Name:
*Address:
*City:   *State:   *Zip:
*Telephone:
*Contact:
Three Trade References
  Reference 1:
   *Name:
   *Address:
   *City:   *State:   *Zip:
   *Telephone:
  Reference 2:
   *Name:
   *Address:
   *City:   *State:   *Zip:
   *Telephone:
  Reference 3:
   *Name:
   *Address:
   *City:   *State:   *Zip:
   *Telephone:
Please send OSHA 200/300 forms under separate cover to PSDinfo@waukesha.spx.com immediately after submitting this form.

 
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