Company Name Office Phone Number Company Email Address Address City Zip State Is your company currently a Certified Diversified Business (ex: MBE, WBE, SBE, etc.)? Please attach copies of Diversity Certificates here Project Experience in the last three years A current Certificate of Insurance indicating General Liability and Workers Compensation coverage must be provided to Regas Contracting prior to any contract issuance. If you do not carry Workers Compensation insurance, a waiver is acceptable. Please attach a copy of your W-9 Type of Services Offered Shipping/Delivery Areas Shipping/Delivery Texas Areas Material Supplier of: Project Types Please select from the work locations below Texas Regions Trades Select Acoustics Trades Select Building Finishes Trades Select Flooring Trades Select Masonry Trades Select Metals Trades Select Millwork & Countertops Trades Select Plumbing Trades Select Site Utilities Trades Other Trades First Name Last Name Email Address Estimator Phone Number Should this contact be used for any of the other following communications? First Name Last Name Email Address Phone Number Please select the type(s) of communications for this contact to receive. First Name Last Name Email Address Phone Number Please select the type(s) of communications for this contact to receive. First Name Last Name Email Address Phone Number Please select the type(s) of communications for this contact to receive. Additional Comments Date Submitted Actions
heather@fdicreative.com 11111 houston 77070 TX test Acknowledge 69c57a6eaa8c8-00-regas-about.png *Ground Ups|*Remodels Acknowledge #ALL TEXAS|#ARIZONA|#ARKANSAS|#COLORADO|#LOUISIANA|#NEW MEXICO|#OKLAHOMA|#TENNESSEE|#UTAH #CENTRAL TEXAS|#EAST TEXAS|#NORTH TEXAS 08-500|Acoustics +|02-090|02-510|Building Finishes +|07-200|03-050|02-050|02-200|16-050|02-275|16-720|15-305|Flooring +|06-100|09-986|15-500|02-900|Masonry +|Metals +|Millwork & Countertops +|02-580|02-830|Plumbing +|01-713|02-525|07-400|09-988|08-400|01-180|Site Utilities +|07-100|OTHER 09-130 09-250|09-900 09-310|09-700 test 04-050 05-500|05-520 06-220|06-435 15-400|02-600 02-600|02-700 test 2026-03-26 18:26:54
heather@fdicreative.com 11111 houston 77070 TX test Acknowledge 69c579995fbcb-00-regas-about.png *Ground Ups Acknowledge #ALL TEXAS|#ARIZONA #ALL TEXAS 08-500|Acoustics +|02-090|02-510|Building Finishes +|02-275|Flooring +|Masonry +|Metals +|02-580|Plumbing +|Site Utilities +|OTHER 09-130 09-250 09-310 04-050 05-500 15-400 02-600 test test 2026-03-26 18:23:21
heather@fdicreative.com 11111 houston 77070 TX test Acknowledge 69c578da7bfd5-00-regas-about.png #CENTRAL TEXAS|#PANHANDLE TEXAS 09-130|09-250|16-050 test 2026-03-26 18:20:10
heather@fdicreative.com 11111 houston 77070 TX 69c5761e85ec8-00-regas-about.png test Acknowledge 69c5761e88989-00-regas-about.png #ALL TEXAS 09-130|04-050|08-100|16-050|06-220|09-986|09-500|06-170|OTHER test test test 2026-03-26 18:08:30
heather@fdicreative.com 11111 houston 77070 TX test Acknowledge 69c56a689db5c-00-regas-about.png #CENTRAL TEXAS|#EAST TEXAS Acoustic Ceiling Systems test 2026-03-26 17:18:32

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