Fillable 2020 CUPCCAA Registration Form (Merced County Office of Education)

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2020 CUPCCAA Registration Form (Merced County Office of Education)

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The 2020 CUPCCAA Registration Form (Merced County Office of Education) form is 2 pages long and contains:

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  • 40 check-boxes
  • 37 other fields

Country of origin: US
File type: PDF

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1
Merced County Office of Education
2020 CUPCCAA Registration Form
VENDOR/CONTRACTOR INFORMATION:
DIR Registration No.: ______________________________________________________________________________
Business Name: ___________________________________________________________________________________
Business Address: _________________________________________________________________________________
Contact Name/Title: _______________________________________________________________________________
Telephone Number: _______________________________ Fax Number: ____________________________________
Email Address: ___________________________________________________________________________________
Cal
ifornia Contractor License Number(s) Class of Contractor License(s) Held
Please check the box(es) for the type of work that you are licensed to perform and are interested in
contracting with the Merced County Office of Education for, through the informal CUPCCA bid process:
Boiler, Hot Water Heating & Steam Fitting Masonry
Building Moving, Demolition Ornamental Metals
Cabinet, Mill Work & Finish Carpentry Painting & Decorating
Concrete Parking & Highway Improvement
Construction Zone Pipeline
Drywall Plumbing
Earthwork & Paving Refrigeration
Electrical, General Roofing
Electrical, Signs Sanitation System
Elevator Installation Sheet Metal
Fencing Solar
Fire Protection General Manufacturing Housing Contractor
Flooring & Floor Control Steel, Reinforcing
Glazing Steel, Structural
Insulation & Acoustical Swimming Pool
Landscaping Tile, Ceramic & Mosaic
Lathing & Plastering Heating, Ventilating & Air Conditioning
Limited Specialty Water Conditioning
Lock & Security Equipment Welding
Low Voltage Systems Well Drilling
2
Please indicate , in detail, what type(s) of work your firm performs, especially if not described by the general
classifications listed herein:
SCHOOL DISTRICT REFERENCES:
This section must be completed. Please include contact infor mation for a minimum of three (3) school
districts in which your company has performed public works projects:
District Name
District Address
Contact Name
Phone/Email
District Name
District Address
Contact Name
Phone/Email
District Name
District Address
Contact Name
Phone/Email
District Name
District Address
Contact Name
Phone/Email
District Name
District Address
Contact Name
Phone/Email
CONTRACTOR CERTIFICATION:
I certify, to the best of my knowledge, the elements of information provided herein are accurate and true, as of this date. I am
properly licensed and skilled to perform the indicated work, and should I be selected for a public works project, I am able to
secure bonds to perform the work. Furthermore, my company shall comply with all city, state and federal requirements.
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Company Name
Date
Printed Name and Title
Authorized Signor
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2020 CUPCCAA Registration Form (Merced County Office of Education)

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Completed 11 May 2021

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