b'COMPANY NAME: ________________________________________________________COMPANY ADDRESS: ____________________________________________________CITY ______________________________ STATE______________ZIP_____________PHONE ____________________________FAX ________________________________URL: ___________________________________________________________________In Business Since______________ DBX Member Reference: ____________________________ Primary Contact Person: _________________________________________________________Email Address: _________________________________________________________________ Additional Contact Names: Email Address _________________________ ________________________________________ \x03Architect\x03Conveying Systems\x03Fire Protection\x03Millwork \x03Asphalt/Paving\x03Doors/Hardware/ \x03Floo ring/Marble/Tile\x03Painting/Dcor \x03Attorney/Law Partitions\x03General Contractor\x03Roofing \x03Banking/Financial\x03Drilling Consultants\x03Glass/Glazing/Windows\x03Sheet Metal \x03Bonding/Insurance\x03Drywall/Plaster/Ceiling\x03Insulation\x03Steel Erection/Fab. \x03Carpentry \x03Electrical\x03Labor Union\x03Supplier \x03Communications\x03Elevators\x03Landscaping \x03Trade Association \x03Concrete\x03Engineer\x03Masonry\x03Underground Utilities \x03Concrete/Masonry \x03Equipment Rental\x03Mech./HVAC/Plumbing\x03WaterproofingSupplier\x03Excavating\x03Mechanical/HVAC Supplier\x03Wrecking \x03Construction Svcs\x03 Fencing \x03Other _____________\x03\x03Labor Affiliation:Union, Non-Union, Not ApplicableCertifications: SBE, DBE, FBE, MBE, EDGESend me info on BX OF DAYTON:Workers Comp Discount Program Health Insurance ProgramLegal Services PlanLegislative Activities Committee Participation Drug Free Workplace Training \x03Member Vehicle Program\x03 TekCollect National Processing SolutionsBeeline Purchasing Brokers \x03 This application for membership into the Builders Exchange of Dayton is made subject to the Bylaws and Rules governing such membership. It isunderstood and agreed that, if and when approved by the Board of Directors, the applicant shall maintain his/her membership in good standing and shall terminate if only in writing and only after all obligations to the Builders Exchange of Dayton have been met.Please indicate level of service: Bronze: Annual Membership for Greater Dayton Area Company:$725.00Silver: Membership plus Online News and Reporting Service:$975.00 \x03 Gold: Membership, News and Reporting Service, plus *Full Online Service Upgrade :$1635.00 Annual Membership for DBX Workers Comp Group Participants located outside of Greater Dayton Area:$100.00 *(Full Online Service Upgrade includes access to all plans and specs online from any computer) \x03\x03 Enclosed is a check made payable to Builders Exchange of Dayton Or pay by credit card below:\x03Visa\x03MasterCard\x03American Express\x03DiscoverCard Number _________________________________Exp. Date _________________CSV________Signature __________________________________________Billing Zip _________________Please return application and payment to: BX of Dayton - 7250 Poe Ave Ste 410 - Dayton, Ohio 45414 - Fax: (937) 278-3843 9-15-2022'