Company Name:  


Owners Name: (Required) 


Additional Owners include Titles:  


Type of Business Entity:  


Contractor Number:      Name on License:  

Years at Present Location:      Former Location if Less Than 4yrs:  


Employees on Payroll:      Workers Compensation Number:  


Insurance Policy Number and Exp-Date:      Insurance Agent:  


Amount and Number of Builders Bond:      Bond Insurance Agent:  


Mailing Address:  


City:         State or Prov: 


Postal/Zip:       Country:  


Phone Number:      Fax Number:  



Email: (Required)



How did you hear about Granby? 
The Internet 
Boundary Canada Timber Homes
Home Show
Magazine 
Newspaper
Television
Yellow Pages 
Word of Mouth 
Other



Regional Customer Base:  



List contacts and Dates of your Last Four Projects: