Fillable Contractor-registration

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Contractor-registration

On average this form takes 9 minutes to complete

The Contractor-registration form is 1 page long and contains:

  • 1 signature
  • 10 check-boxes
  • 29 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Stafford, TX

BROWSE CITY OF STAFFORD, TX (TX) FORMS

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City of Stafford
2610 South Main Stafford, Texas 77477
Office Number (281) 261-3940 Fax Number (281) 261-3939
Contractor Registration Form
Type of Contractor: (PLEASE CHECK ONE) Registration valid for one year from date of issuance
General ___ Mechanical ___ Plumbing ___ Electrical ___ Roofing ___
Irrigation ___
Sign ___
Fire Alarm/Sprinkler ___
Drain Layer ___
Homeowner/Other___
Please provide the following:
1. Valid Texas Driver’s License or ID
2. Copy of State License (if applicable)
3. Copy of State Registration (if applicable)
4. Copy of Insurance Certificate made out to the City of Stafford, 2610 South Main, Stafford, TX 77477
Please Print or Type
Licensed Individual: TDL #:
Home Address: Phone #:
City: State: Zip Code:
State License Number (if applicable): Expiration Date:
Business Information
Company Name:
Office Phone #:
Owner Name:
Cell Phone #:
Mailing Address:
Fax #:
State:
Zip Code:
Email:
List All Persons Authorized To Purchase Permits Under This Registration (Please attach additional sheet)
1.
TDL #:
2.
TDL #:
3.
TDL #:
Email Address:
License Holder/Owner Printed Name Date
Signature Title
Liability Insurance:
All Contractors are required to maintain at least the minimum general liability insurance coverage at all times to satisfy proof of financial
responsibility. The Insurance must:
be at least $ 300,000.00 per occurrence (combined for property damage and bodily injury); and
be at least $ 600,000.00 aggregate (total amount the policy will pay for property damage and bodily injury coverage); and
be at least $ 300,000.00 aggregate for products and completed operations.
Office Use Only: Registration #:__________
Expiration Date:
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Contractor-registration

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Completed 12 February 2020

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