VENDOR APPLICATION

 INDIVIDUAL SOLE PROPRIETOR PARTNERSHIP CORPORATION LLC LLP

 Yes No

PRINCIPALS OF COMPANY

CREDIT/TRADE REFERENCES

COMPANY INFORMATION

 LESS THAN 50K 50K-100K 100K-250K 250K-500K 500K-1 MILLION 1 MILLION – 2 MILLION 2 MILLION +

 LESS THAN 50K 50K-100K 100K-250K 250K-500K 500K-1 MILLION 1 MILLION – 2 MILLION 2 MILLION +

 Residential Commercial Industrial Government

RECENT PROJECTS

LIST YOUR LAST 3 COMPLETED PROJECTS ALONG WITH JOB VALUE AND SITE LOCATION

By signing above the undersigned guarantees that all information contained herein is true and accurate. Any incorrect or misleading information is grounds for termination and or rejection by Rossi Construction of the undersigned.