Fillable APPLICATION FOR CODE ENFORCEMENT CONTRACTOR REQUIREMENTS FOR CODE (City of Gulfport Mississippi)

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APPLICATION FOR CODE ENFORCEMENT CONTRACTOR REQUIREMENTS FOR CODE (City of Gulfport Mississippi)

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U.S.A. forms for City of Gulfport Mississippi

BROWSE CITY OF GULFPORT MISSISSIPPI (MS) FORMS

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APPLICATION FOR CODE ENFORCEMENT CONTRACTOR
REQUIREMENTS FOR CODE ENFORCEMENT CONSIDERATION FOR CONTRACTOR BIDDING
CITY OF GULFPORT
URBAN DEVELOPMENT – CODE ENFORCEMENT
1410 24
TH
AVENUE
• Completion in its entirety of the application including notarization.
• Submission of a copy of a current Business Privilege License from the jurisdiction (municipal or county)
where your business and/or company headquarters is located.
• To bid on demolition jobs, submission of a copy of a current Building Code Contractor’s License with
the City of Gulfport.
• Submission of valid photo identification of primary contractor who holds current Business Privilege
License.
• OPTIONAL: Submission of a notarized authorization letter from qualifying contractor authorizing
others to act on his/her behalf.
If you have any questions, you may contact Code Enforcement at
Phone: 228-868-5718
Fax: 228-214-4487
COMPLETE AND SIGN THE APPLICATION ON PAGE 2
2
Name of Applicant:
Name of Business:
Street Address:
Mailing Address:
City/State/Zip:
Home Phone:
Work/Cell Phone:
Email Address:
Certifications/Licenses
License/Registration Number
City or County of Issuance
I HEREBY CERTIFY that this application contains no willful misrepresentation or falsification; that the
information given by me is true and completed to the best of my knowledge and belief. I am aware that
should investigation at any time disclose any such misrepresentation or falsification my application may be
rejected and my name removed from the list, and disqualified from applying in the future for any contract
award bids for Code Enforcement.
Signature:
Date:
APPLICATION - CODE ENFORCEMENT CONTRACTOR
3
URBAN DEVELOPMENT
CODE ENFORCEMENT
1410 24
TH
AVENUE, GULFPORT, MS 39501
PHONE: (228) 868-5718 FAX: (228) 214-4487
WEBSITE: http://www.gulfport-ms.gov/
SUBMISSION OF AUTHORIZATION LETTER
**OPTIONAL – ONLY IF SOMEONE WILL BE ALLOWED TO SUBMIT BIDS ON YOUR BEHALF**
THIS LETTER MUST BE NOTARIZED OR IT WILL NOT BE ACCEPTED
CONTRACTOR:
COMPANY NAME:
THE FOLLOWING INDIVIDUALS HAVE AUTHORIZATION TO ACT ON MY BEHALF.
(Signature of Contractor)
(Print Name)
Subscribed and affirmed before me in the county of ___________________, State of
_______________________, this day _______ of __________________, 20_____.
(Notary’s Official Signature)
(Commission Expiration)
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APPLICATION FOR CODE ENFORCEMENT CONTRACTOR REQUIREMENTS FOR CODE (City of Gulfport Mississippi)

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Completed 23 January 2021

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