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Kloloradco <br /> rocnrement STATE OF COLORADO <br /> egistry p <br /> Procurement Registry <br /> �4_ 10f e°lorod°Business <br /> taa*d SwP'^`•`^"� ew.+n`w'Qd Crm— <br /> s a master list of <br /> s that may be used <br /> the <br /> The St <br /> ate of Colorado,through its Department of Regulatory Agencies,m a by <br /> discretionaryState employees wlto make purchasing decisions.s <br /> discretionary procurement process. The list is posted on our web site our firm will be registered on that list. If this form is <br /> completing this form and returning it with the requested documents,y <br /> By comp g not be registered. Questions about the registry should be <br /> returned incomplete or without the supporting documents your firm may <br /> form and requested documents to: <br /> directed to(303)894-2355. Please return the completed <br /> Division of Minerals and Geology <br /> 1313 Sherman St.,Rm.215 <br /> Denver,CO 80203 <br /> FEIN 84 0647637 <br /> 1. Legal Name of Business S accamonti Excavatiny Inc. <br /> List dba,if any <br /> 2. Mailing address 18 s en i <br /> City Pueblo <br /> State CO Zip+4 R 1006 <br /> 3. Business phone 719 544-8943 <br /> Fax 544-6688 <br /> 4. E-mail address SPACCAMONTI @ CODE NET.NET <br /> Web address <br /> 5. Name of Contact person: Last <br /> S accamonti' First <br /> Type of work the company performs(use sic codes found at www.dora.state.us/ 6862 <br /> 9/ <br /> Cenificationlsic.htm)0 � 16 2 2/1 6. 111 <br /> 7. Ownership information (use additional pages if necessary): __ <br /> .;.. 1"IItST2dAME s"� " w r MID�t is . 'ID > .:SFE`8F3.OW?• ( `!!BEIASL').. <br /> 0� <br /> UST NAA r _' 'r ti act 4 +� f r IIZtIIAL <br /> 4` IOT <br /> Madaline 57 Female <br /> Spaccamonti 43 Male OT <br /> Johnn C. <br /> S accamonti I <br /> ill All �r . GIs EttitllC[t�co <br /> ae3 a x <br /> codes .Ma�l� �_• g `"`:C. sianPaafic.. .� v� .�VH <br /> . R= 5�1' �iw.T"yyl� .�w`a",•7�. t7n$le'b'..,.�'.,."' ,�'t .i'. "a Bir"G�. slltC,�IIOn 'dT1IC)�..y _ <br /> t. ya.-w 4 yaw 3rx. ^ ~",,x `t.i. w•v� �BBClC r <br /> �--�' '��..�; .� <br /> •q °..s�•3 �'ti-� <br /> 8. Is your company registered on the BIDS system? Ya NC]. <br /> Title Date 4/11/2000 <br /> President <br /> Signature U,", ¢._ t <br /> r <br /> V;c;t thc�e web sites for information on BIDS:+ +�.¢ssa.stame.co.us;DBE Certification:w�tiv.donstau.ce.us/Ccrtification <br />