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List of Qualified Contractors Form (2012-2013)
Please complete all of the following information to have your firm included on the City of Indio and Indio Redevelopment Agency and Indio Water Authority 2012-2013 List of Qualified Contractors to receive Notices Inviting Informal Bids for Public Projects in accordance with the Uniform Public Construction Cost Accounting Procedures. All fields are required and firms filing incomplete request forms will not be added to the Bidders List. For more information on the California Uniform Public Construction Cost Account Act go to www.sco.ca.gov/ard_cuccac. For questions or assistance regarding this form please contact Maria Ysiano in Public Works Administration at (760) 391-4042 or mysiano@indio.org.
Company Name:

Contact Person:

Street Address (Address to which invitations for bids are sent):

City:

State (Abbreviation):

Zip Code:

Phone Number with Area Code:

Fax Number with Area Code:

Email Address:

Contractor License Number:

Name of License Holder:

Class of Contractor's License(s) held (please specify Classification and Code):

Type of work interested in and currently licensed to perform (e.g. earthwork, pipelines, electrical, painting, general building, etc):

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