Subcontractors

Work with Regas Contracting

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Interested in being a subcontractor for Regas Contracting?

Please provide your contact details and a description of your company.

Company Name*

Please enter your company name.

Office Phone number separated by dashes*

Please enter your phone number.

Office Fax*

Please enter your fax number.

Address*

Please enter the street.

City*

Please enter the city.

State*

Please enter state.

Zip*

Please enter Zip.

Name*

Please enter your name.

Cell Phone number separated by dashes*

Please enter your phone number.

Email*

Please enter your email address.

Work History

How many years have you been in business?*

Please enter the years.

Have you worked with Regas Contracting in the past?*

YesNo

Please make a selection.

Additional comments

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Insurance Information

Insurance Company*

Please enter your insurance company name.

General Liability Coverage Amount?*

Please enter your general liability amount.

Workers Compensation Coverage Amount?*

Please enter your workers comp amount.