Small Works Roster Application 2021

VALLEY VIEW SEWER DISTRICT
SMALL WORKS ROSTER APPLICATION 2021

The completion and submission of this form constitutes formal application for
consideration in awarding contracts through the Small Works Roster process for Valley View Sewer District as provided in RCW 57.08.050.
Business Name
Business Type

Corporation Partnership Sole Proprietorship Joint Venture Other
Business Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone:
Fax:
Email
Federal EIN:
WA State Contractor's License Number:
City Contractor's License:
Contractor must be able to acquire a Business License for the cities of Burien, SeaTac,
and Tukwila if necessary.
SCHEDULE OF RATES:
List men and equipment, and hourly and daily rates.
Please include prevailing wage labor rates.
EMERGENCY NAMES AND NUMBERS
Name:   First Name   Last Name   Phone:   Area Code   Phone Number
Name:   First Name   Last Name   Phone:   Area Code   Phone Number
Name:   First Name   Last Name   Phone:   Area Code   Phone Number
REFERENCES
List three public sewer or water agencies whose jurisdiction you have worked in:
Agency:   Water or Sewer District    Phone:   Area Code   Phone Number
Agency:   Water or Sewer District Phone:   Area Code   Phone Number
Agency:   Water or Sewer District Phone:   Area Code   Phone Number