CR Structures Vendor Application

Form
Vendor Registration Form

Thank you for your choosing to work with CR Structures Group, Inc. Vendors are an integral part of our process and help us put together a cohesive team for each project. Please complete and submit this form to start the registration process. If you have any questions, please contact us at (920)733-7305.We look forward to working with you.
Your Name*

First NameLast Name
Your Email*
example@example.com
Your Company Name*
Company Description (Specialties, Trades, Preferences)*
Company Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Phone Number*
Please enter a valid phone number.
Company Fax Number
Please enter a valid phone number.
Website
Accounts Payable Contact*

First NameLast Name
Accounts Payable Phone Number*
Please enter a valid phone number.
Accounts Payable Email*
example@example.com
Accounts Receivable Contact*

First NameLast Name
Accounts Receivable Phone Number*
Please enter a valid phone number.
Accounts Receivable Email*
example@example.com
Firm Type*

CorporationPartnershipSole ProprietorshipJoint Venture
Is your ﬁrm a minority-owned business?*

YesNo
If yes to a minority-owned business, which type?

DBEWBEMBE
Name(s) of Owner(s) or Major Stockholder(s)*
Name of the Company President*

First NameLast Name
Years in Position (of the Company President)*
Have there been any changes in ownership or management in the last 5 years?*
If Yes, please explain
Is your company now, or has it ever been, involved in bankruptcy or reorganization proceedings?*

YesNo
Are there any pending judgments, claims, or suits?*

YesNo
Current Number of Employees*
Annual revenue for each of the last (3) years*
Your Bank Information*

Name

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Bank's Contact Person*

First NameLast Name
Your Bank's Contact Person's Phone*
Please enter a valid phone number.
Product Line(s)*
(Brand Name Example: Pella Windows)
Please provide a brief company history*
Please attach a copy of your company's W9. *

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Please attach a copy of your company's current Certiﬁcate of Insurance (COI) with Workers Compensation and Commercial General Liability coverage limits.*

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How did you hear about CR Structures Group, Inc.?
Type of vendor you are registering as:*

SubcontractorSupplierService ProviderConsultant
Complete the following for Subcontractors only
Estimator's Name

First NameLast Name
Estimator's Phone
Please enter a valid phone number.
Estimator's Email
example@example.com
Member of these organizations? (check all that apply)

ABCUnionApprenticeship ProgramNortheast Wisconsin Construction Alliance
Percent of your work that is Design/Build (check only one)

0%10%20%30%40%50%60%70%80%90%100%
Percent of your work that is Bid Spec (check only one)

0%10%20%30%40%50%60%70%80%90%100%
Workman's Comp. Experience Mod Rate Factor (EMR) for the current year
OSHA Recordable Incident Rate for last year
OSHA Recordable Incident Rate for two years ago
OSHA Recordable Incident Rate for three years ago
Do you have any OSHA citations within the last ﬁve (5) years? (If Yes, please complete the next ﬁeld. If No, please skip to Company Description.)

YesNo
If you do have any OSHA citations within the last ﬁve (5) years, please attach an explanation and copies of citations).

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CSI Divisions Bidding (check all that apply)

1 - General Requirements2 - Existing Conditions3 - Concrete4 - Masonry5 - Metals5 - Steel (PEMB) Erection Labor6 - Wood, Plastics or Carpentry6 - Rough Carpentry Labor6 - Finish Carpentry Labor7 - Thermal/Moisture Protection8 - Openings9 - Finishes10 - Specialties11 - Equipment12 - Furnishings13 - Special Construction/PEMB14 - Conveying Equipment21 - Fire Suppression22 - Plumbing23 - HVAC26 - Electrical31 - Earthwork32 - Exterior Asphalt/ Landscaping/ Fencing/ Curbing33 - UtilitiesOther
Please attach a copy of your OSHA 300 Logs for the last ﬁve (5) years if you have more than 10 employees.

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Geographic Preferred Work Area (check all that apply):

NE WisconsinNW WisconsinSE WisconsinSW WisconsinMidwest United States
Please attach a copy of your company's Comprehensive Safety Program and Safety Manual.

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Should be Empty:

Form

Vendor Registration Form

Complete the following for Subcontractors only