Construction Contractor Registration

The County invites all interested licensed contractors to submit their company for inclusion on the qualified contractor list for the current calendar year. Applications received after December 1st will be added to the next calendar year. Please provide all applicable information below.

Click here to view the current contractor list.

Thank you

Construction Contractor Registration

Contractor/Business Information:

Contractor’s Legal Name: *

Contractor’s DBA Name (if applicable):

Business Address (Street): *

Business Address (City): *

Business Address (State): *

Business Address (Zip Code): *

Contact Name: *

Phone Number:

Fax Number:

Email Address: *

Email Address: (Alternate Contact)

Contractor License Information:

Please include all work that you are licensed to perform and are interested in contracting with the County for.

GENERAL CONTRACTOR:

Contractor’s License Number(s):

Contractor License Type

A - General Engineering Contractor
B - General Building Contractor

SPECIALTY CONTRACTOR:

Contractor’s License Number(s):

Other type of work performed:

DIR Registration Information:

Department of Industrial Relations Registration Number: *

Contractor Certification:

I certify, to the best of my knowledge, the information provided herein is accurate and true,
as of this date. I am properly licensed and skilled to perform the indicated work.

Name and Title

Date

Address

Address Line 1

Address Line 2

City

State

Zip Code

Construction Contractor Registration

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Construction Contractor Registration

Contractor/Business Information:

Contractor License Information:

GENERAL CONTRACTOR:

SPECIALTY CONTRACTOR:

DIR Registration Information:

Contractor Certification:

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