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2. Contractors interested in bidding on the City's rehabilitation projects mentioned on the previous page are asked to submit an interest form below. You will be contacted at a later date to provide additional information such as, but not limited to: references, W-9, copy of State Contractor's license, proof of Insurance, etc.

4. Insurance must be equal to, or exceed the following requirements:

   • Worker's Compensation and Employers Liability - $1,000,000 per occurrence.
   • General Liability - $1,000,000 per occurrence/$2,000,000 aggregate for bodily injury, personal injury, and property damage.
   • Automobile - Cover all vehicles used in the performance of the contract providing bodily injury liability limits of not less than $500,000 for each person and $500,000 for each accident or occurrence.  Also, provide property damage liability limits of not less than $500,000 for each accident or occurrence that may arise from the operations of the contractor in performing the project.
8. Housing Rehabilitation Program - Contractor Interest Form
10. Company/Contractor Name*
12. Address*
14. City*
15. State*
16. Zip*
18. Telephone Number*
19. Email Address*
20. State License Number*
22. Name of Person Filling out this Form*
23. Title of Person Filling out this Form*
25. Certification of Non-Discrimination by Contractor*

    I hereby certify that my contracting firm does not discriminate in its employment with regard to race, color, religion, sex, or national origin; that it is in compliance with all Federal, State, and local directives and executive orders regarding non-discrimination in employment; and that it agrees to demonstrate positively and aggressively the principle of equal opportunity in employment.

    1. I agree
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

* indicates a required field