Contractor Registration

Help information for Name of Contractor
Example: Michael James Smith, no nicknames
Help information for Name of Business
Example: ABC Contractors
Help information for Address of Business
Example: 100 N. Main, Itasca
Help information for Cell Phone #
Example: 123-123-1234, dashes are required.
Help information for January - June 30th
License for the year.
Help information for July - December 31st
Only if submitting payment after June 30th.
Subtotal Amount
Service Fee
Payment Amount