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Wahkiakum County Small Works Roster Application

  1. ATTACH A COMPLETED W-9 TAX FORM WITH APPLICATION

  2. INCLUDE SPECIALTY PREFERENCE (see below)

  3. By signature below, I acknowledge that I have read and understand the requirements described in this application, and to the best of my knowledge, information provided is a true representation of the named firm's ability to perform any contracts which may result by my submittal of this application.

  4. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  5. Indicate the categories that best describes the type of work your firm is qualified to perform:

  6. Public Works

  7. General Construction - Streets

  8. General Construction - Utilities

  9. Specialty Contractors

  10. Public Buildings

  11. Construction - Buildings

  12. Leave This Blank:

  13. This field is not part of the form submission.