Subcontractor Information Sheet           Your Company Name: Company Address: Telephone Number(s):     /FEIN:   Office:   Cell:     State Of Incorporation/Organization: Names OF Company Officers/Members:     Your Name: /SSN: Your Email Address: Your Address: [if different from company] Telephone Number(s):     Home:   Cell:     Type(s) Of Work You Do: Type(s) & Age Of Equipment: [designate ‘owned’ or ‘leased’] Experience & Prior Jobs: Number Of Employees: Number Of Crews Available: Number Of Subcontractors Used: Earliest Date Available: Are You Willing to Travel? Yes No States In Which Your Company Is Licensed To Work     Subcontractors must obtain & Maintain Specific Types & Limits Of Insurance. Does Company Have The Ability To Fulfill Our Insurance Requirements? Yes No     On Your Employees/Personnel, Do You: Properly Complete I-9 Forms Yes No     Conduct Background Checks Yes No     Require Drug Tests Yes No     How Did You Find About ECI?             **Acceptance of this form by ECI Telecom Inc., is not a guarantee of future work. No expectation of future work is created by filling out this form and submitting it to ECI Telecom, Inc. ECI Telecom, Inc. is an equal opportunity company. ECI Telecom does not discriminate on the basis of race, creed, color, gender, age, ethnicity, national origin, religion, physical handicap or disability.                     Aerial / Underground Construction       Technical / Fiber Services       Directional Drilling       Sales & Audit       Installations & Fulfillment       Disaster Relief
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