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Brief description of
type of work you do |
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Number Of Employees |
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Annual Emp. Payroll $ |
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Annual Gross
Receipts | |
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Amount paid annually
to sub-contractors |
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Any Claims during the last 3
years? | |
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If yes, please describe loss and show
loss amt. here. | |
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| Computer/Software
Consultants |
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Do you provide Internet Services: |
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Do you provide web hosting Services: |
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Give a description of services
provided: |
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Do you Design Software: |
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| If yes, will this software be sold to the
general public: |
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Please describe how the software will
be used: |
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Do you work on New Residential
Tracts? | |
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If yes, list max. # of
units | |
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Do you work on New Condo or Apartment
Complexes? | |
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HUCKABY & HUCKABY INSURANCE
SERVICES "Serving Californians Since
1972."
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