If you are properly licensed or registered to perform work in the State of Washington and wish to be placed on the Port of Kennewick's Small Works Roster, the following application must be completed. Incomplete applications will not be accepted. PLEASE NOTE THE PORT OF KENNEWICK COMPLIES WITH THE PREVAILING WAGE LAW OF THE STATE OF WASHINGTON (RCW 39.12) AND REQUIRES ALL CONTRACTORS TO COMPLY. All applications will be kept on file indefinately. It will be the responsibility of the company to notify the Port of Kennewick of any changes in services provided. Please direct questions to Sherrie Bowers at 509/586.1186, regarding this application, procedure, or to determine if you are currently listed on the roster.

Name of Company
Business address
City, State, Zip
Phone number (include area code)
Fax number (include area code)
Name of contact person

Type of business: check appropriate
Incorporated	Partnership	Sole Proprietorship

Federal Tax Identification #
State of Washington contractor's registration #
Name of bonding company
Amount of bond

Licensed as: (Check appropriate)

General Contractor (please list type of work you are interested in bidding)

Specialty Contractor (please check specialty/specialties)

Asphalt/Repair	Gutters/Downspouts	Sanitation Systems
Carpentry/Framing	HVAC	Scaffolding
Carpet Laying	Irrigation	Sheet Metal Fabrication
Concrete	Landscaping	Siding (other than wood)
Docks	Painting/Wallcover	Signs (non-electrical)
Electrical	Paving/Striping	Snow Removal
Excavating/Grading	Photography	Steel Aluminum Erectors
Fencing	Plumbing	Telecom/Cable Wiring
Fire Protection System	Rail Repair/Maintenance	Utilities
Glazing/Glass	Roofing	Welding/Fabrication

Other (specify)

Date
Prepared By
Title