Webber Vendor Application Vendor Application to do business with Webber Step 1 of 6 16% Vendor InformationCompany Name*Primary Contact* First Last Primary Contact Email* Certified Payroll Contact* First Last Certified Payroll Email* Payment Reporting Contact* First Last Payment Reporting Email* Tax ID Number*(Federal Tax ID)Company Type* Save and Continue Later Certification Is your business certified as a DBE, MBE, WBE, SBE, 8(a) or HUB? *Check all current certification types that apply and include certifying agency/ies, certification #, and next renewal/expiration date. Note: If your firm is currently certified, you are required to attach a copy of your certificate(s) or approval letter(s) in the document list section below.* Not Applicable Disadvantaged Business Enterprise (DBE) Historically Underutilized Business (HUB) Minority Business Enterprise (MBE) Women Business Enterprise (WBE) 8 (a) Small Business Enterprise (SBE) Other Certifying agency/ies, certification number, and renewal date (if applicable)*Attach a copy of your certificate(s) or approval letter(s)* Drop files here or Accepted file types: doc, pdf. Please indicate the ethnic group of your certified firm?*Not ApplicableHispanicBlackAsianNative AmericanCaucasianOtherPlease indicate the gender of the certified firm ownership.*Not ApplicableMaleFemaleOther Save and Continue Later Familiarity with state Departments of Transportation (DOT) and ContractorsHave you ever bid on work for a Webber project?*YesNoHave you ever performed or bid work on a Webber project?*YesNoIf yes, please list the name of the projects. Limit your answer to 1000 characters or less:*Have you ever bid on a state(s) Department of Transportation project?*YesNoIf so, indicate which state(s) have you submitted bids. Limit your answer to 1000 characters or less:* Save and Continue Later Largest Projects CompletedHas your firm completed infrastructure projects in the past 5 years?*No - Not ApplicableYesIf yes, indicate the number of projects.* Save and Continue Later Additional Information About Your FirmWhat was your approximate annual contract income last year?*(Round Dollar Amount)What is the address of your company headquarter office* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code What states have you worked in?*List all that applyHow many active projects do you have currently?**Of the active projects you currently have, are any infrastructure projects?*NoYesIf so, please indicate what type of projects- highway, airport, water, etc*For design build highway projects performed as construction, indicate the number of crews your company used to perform this work*If not applicable, type “n/a” in the box above:Have you performed work on public works projects?*YesNoIf so, please indicate federal, state, local, city or county work and when this work was performed.*Have you performed work on airports projects?*YesNoIf so, please indicate federal, state, local, city or county work and when this work was performed.*Have you performed work on water or water treatment projects?*YesNoIf so, please indicate which entity, project and what type of work and when this work was performed.*Have you performed work on any highway projects for an entity other than a state DOT?*YesNoIf so, please indicate which entity, project and what type of work and when this work was performed.*Do you own or lease your equipment? (check all that apply)* N/A Lease Own Indicate what equipment is owned. If trucking firm, indicate how many trucks are owned and insured under your company name. Limit your answer to 1000 characters or less.If you prefer to attach a document providing your list, type 'Document Attached' in the text box below and attach your document.Include all equipment owned. Accepted file types: doc, pdf, jpg.Do you typically subcontract/sublet any of your work?*YesNoIndicate what scope of work you typically subcontract/sublet*Please indicate your current number of employees.*Does your company have bonding capacity?*YesNoIf yes, indicate the current amount of your company’s bonding capacity. Include the dollar amount your company is bonded for and/or potential bonding capacity.*Does your company carry insurance?*YesNoIf yes, indicate type of insurance carried. Include the dollar amount insured for or can be insured for each insurance type.* Save and Continue Later Work CapabilitiesAssigned Work CodesPlease add any Commodity Codes that represent the products and/or services provide by the business. (one per line)PhoneThis field is for validation purposes and should be left unchanged. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.