Supplier/Subcontractor Bid List Form

BROM likes keeping current with innovative products and services to offer the very best alternatives to our clientele. If you have a quality product or service that you would like us to consider, please fill out the form below. This information will be forwarded to the appropriate person for review.

Note: All fields are required. If a field is not applicable to you, please indicate with "NA".

Your name   
Business name   
Street address   
City   
State   
Zip Code   
Office phone   
Cell phone   
Fax   
E-mail   
Contact person   
Best time to reach you   
Main product(s) or service(s)
(Describe briefly)		   
Service area   
Type of company/organization    Sole proprietor
   Corporation
   Partnership
   LLC
Does your company have a current Connecticut DAS Certificate?
(If "No" and you're interested in becoming certified,
go to the L1 & L2 sections of the Supplier/Subcontractor webpage
for additional information.)		    Yes - MBE
   Yes - SBE
   No
Year business was established   
Number of people in your Work Crew   
Type of insurance    General Liability
   Workers Compensation
   Both
   Not applicable
Do you have a contractor license?    Yes
   No
   
We encourage you to forward your business
flyer, brochure or business card to us.
(See "Contact Us" for mailing address/fax info.)
Comments/Questions