pat@greatwesternpainting.com    Fax - 413-618-7494   Pat  1 - 877-749-5554  Home Page                                                                             Bridges  -  Form Date                                              Name Company      Phone Office Cell Fax Location  Address Email City     State   Zip Contractor / General  Infomation Contact  Name     Company      Phone Office Cell Fax Email Location  Address City     State   Zip   Bridge Lenght     Height             Total  FT.                                                                                                                                     Access   Easy     Hard     Over Water    Yes    No     Land   Yes    No   Scope of work includes:     Girders    Columns    Retaing walls    Steel decking       Miscellaneous         Total  FT.  Sand Blast  -  Normal    White metal    Grind and scrap only     Sand Cost     Water Blast Get Sand - Pots - Hoods  where Contact  Name     Company      Phone Office Cell Fax Location  Address City     State   Zip Type of Paint       Primer     Cost per Gal.   Paint - Ft per Gal         Finish      Cost per Gal.   Paint - Ft per Gal                        Not Sure of kind of paint to use   Paint Company and Rep Infomation Contact  Name     Company      Phone Office Cell Fax Location  Address City     State   Zip Equipment for the project   Lifts  1     2     3     Reach with Boom Lift   Size of boom        FT High Contact  Name     Company      Phone Office Cell Fax Location  Address City     State   Zip  Lift Price Per Day    Per Week  Per Month   • Boom Lifts - Articulating    • Boom Lifts - Telescopic    • Bucket Trucks  • Personnel Lifts   • Scissor Lifts - Rough Terrain    • Scissor Lifts - Slab  Traffic Control    Contact  Name     Company      Phone Office Cell Fax Location  Address City     State   Zip   Approximant Cost Lead Abetment Removal   Yes    No    Amount   Comments