CPT’s Field Subcontractor Application
Company Information
Company Name
Street Address
Apt, Suite #
City
State
Zip Code
Main Phone Number
Please enter a valid phone number.
Website
Main Contact Information
First & Last Name
Title
Email
example@example.com
Phone Number
Please enter a valid phone number.
Phone Type
Please Select
Cell
Office
Home
Is your company Regional or National?
Regional
National
Number of years in business
Number of Employees
Please Select
1
2
3
4
5
6
7-10
50+
Do you have additional dispatch locations other than above?
Yes
No
Check all services you can provide
Voice/Telecom
Audio/Visual
Security (CCTV, Cameras)
Electrical
Cabling
Access Control
Data/Networking
Roll Outs
Access Points
Fiber Installation
Travel Crew
Structured Cabling
Other
What is your first hour rate during normal business hours (7AM-6PM, M-F)
What is your hourly rate during normal business hours (7AM-6PM, M-F)
What is your first hour rate during non-business hours (6PM-7AM, M-F)
What is your hourly rate during non-business hours (6PM-7AM, M-F)
What radius (in miles) can you provide with no additional trip, travel or service fees?
Are you a Union Company?
Yes
No
Does your company carry General Liability insurance with limit of 1,000,000/1,000,000?
Yes
No
Does your company carry Workers' Compensation Insurance with limits of $500,000/$500,000?
Yes
No, we are exempt
Other Amount
Provide any other information you think we should know about your company, including types of jobs, customer references, websites, photo links showing work, examples of projects completed
How did you hear about CPT? (If applicable, please leave the name of the team member who contacted you)
Please verify that you are human
*
Skill Sets
Submit
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