CUPCCAA Registration Questionnaire

BUTTE VALLEY UNIFIED SCHOOL DISTRICT

INFORMAL BIDDING - QUALIFIED BIDDERS LIST APPLICATION

Contact Information for Informal Bidding Notices

Contractor/Applicant Name*

Answer Required

Contact Person Name*

Answer Required

Mailing Address*

Answer Required

Email Address

Answer Required

Mobile Phone

Number Required

Work Phone

Number Required

Fax

Number Required

Contractors' License

License Number*

Answer Required

License Classification(s)*

i.e. Concrete, Framing, Information Technology

Answer Required

License Expiration*

Answer Required

Verification. The undersigned is an employee of the Contractor and is duly authorized to execute and submit this Application to the District on behalf of the Contractor. The undersigned has reviewed the foregoing and has confirmed that the foregoing is complete and accurate.

Signature*

Signature Required

Title:*

Answer Required

Please fix the highlighted areas below before submitting.

CUPCCAA Registration Questionnaire