Providence Community Housing | New Orleans Housing | Affordable Communities

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Company or Individual Name

Contact*

Address

Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Contact Info

Office Phone*

Mobile/Cell*

Email*

Fax

Website

Are you registering for a specific project?*

Yes

All registrations are kept on file for future opportunities, even if the original registration was for a specific project.

Louisiana Business License?*

Union Shop?*

Business Type*

If other:

Business Specialty*

If other:

License Type*

If other:

Number of Years in Business*

Is your business 51% owned and controlled by one of the following HUB groups?

Providence is committed to increasing HUB (Historically Underutilized Business) vendor participation.

If yes, where?

If other:

Is your business a Certified Section 3 entity?

HANO

HUD

Other

Is your business a Certified DBE entity?

City of New Orleans

State of Louisiana

Other

What is your bonding capacity?*

What is your target volume for a single project?*

Relevant Project Experience*

Please describe projects including project name, owner, architect, contract amount, and date completed.

Client References*

List client name, contact info and type of work completed

Bank References*

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Name*

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Last

Company*

Date*

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Contractor Registration

Contractor Registration

Company or Individual Name

Address

Contact Info

Is your business a Certified Section 3 entity?

Is your business a Certified DBE entity?

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