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Prospective Broker Contact Information

The information provided by you will be retained by the County for future reference.
There is no guarantee that your firm will be added to the County's approved broker/dealer list.

Company:  
Contact:  
Address:  
City:   State:   Zip Code: : 
Phone Number:   Fax Number:  
Email Address:  
Website Address:  
1. Over the past five years, have any professionals in the practice been involved in any business litigation or other legal or investigative proceedings related to investment activites?  
Yes     No
2. Please indicate which market sectors below you provide coverage for:   U.S. Treasuries
U.S. Agencies
Commercial Paper
Corporate(Notes)
Negotiable Certificates of Deposit
Bankers' Acceptances
3. Please provide three client references (preferably large government institutions):  
Reference #1
Reference #2
Reference #3
4. Please indicate the total number each of management personnel, sales staff, and traders within your practice:  
Mgmt.
Sales
Trading

The information provided by you will be retained by the County for future reference.
There is no guarantee that your firm will be added to the County's approved broker/dealer list.

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