Irwin & Leighton, Inc.


Subcontractor & Supplier Qualification Form

Qualified subcontractors and suppliers are vital to Irwin & Leighton’s continued success. If you wish to be considered for future project opportunities, please complete the Qualification Form below.

Firm Name:   * - required

Contact Name:   *

Trade:  

Ship to Address:***
*** Note: Shippers will not deliver to a PO Box, please provide physical street address****

Address Line 1:  

Address Line 2:  

City:      State:      Zip Code:  

Phone Number:   *

Fax Number:  

Email Address:  

Labor Affiliation:       Union     Open Shop     Both


Work Regions (check all applicable areas):

Pennsylvania:
       Philadelphia/Five County Area
       Harrisburg/York/Lancaster
       Reading/Allentown
       Scranton/Wilkes-Barre
       State College
       Western Pennsylvania
New Jersey:
       Princeton
       North Jersey
       South Jersey
Other:
       Delaware
       Maryland
       New York/Connecticut
       Washington DC/Virginia

Shipper Name:  

Shipper Number:  

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