*
= Required Field
1.
Company Legal Name
2.
Head Office Address and Contact Information
Building / Street
City
Province / State
Postal / ZIP
Country
Courier address (if different)
Manufacturing plant location (if applicable)
Phone
Fax Number
Toll Free number
Website address
3.
Main Contact for Tenders
Name
Title
E-mail
Direct line
4.
Personnel
President
General manager
Finance officer
Quality manager
Safety manager
5.
Business Information
Date founded / incorporated
Owners / partners name and ownership
Owned subsidiaries (if any)
Company structure (public or private)
Projected annual income (specify currency)
Aboriginal / native ownership (%)
Aboriginal / native affiliation (if any)
Union status (name affiliation, if applicable)
Is the company signatory to any collective bargaining agreements (if yes, please specify)
6.
Permitted to work in
Alaska (provide experience modification rate)
Yukon (provide WCB#)
BC (provide WCB#)
Alberta (provide WCB#)
7.
Please select all relevant service categories
Engineering services
Facilities construction
Pipeline construction
Compressor station equipment
Valves, fittings and flanges
Metering and assemblies
Regulatory services
Construction support
Transport / logistics
SCADA / communications
Environmental coordination / compliance
Safety
Land
Third party inspection
Other
8.
Primary service offering or areas of expertise
9.
Areas of certification
10.
Relevant experience (i.e., previous three jobs)
11.
Additional comments
12.
Do you consent to the Alaska Pipeline Project providing the information on this registration form to other contractors working on the project?
Yes
No