Small-Works-Roster-Form-and-Debarment-Affidavit

Small Works Roster Application
Date

MonthDayYear
Date
Name of Contractor or Vendor
Phone Number
Address
Fax Number
E mail Address
example@example.com
Federal Tax ID or Social Security No.
Registration Number L&I
UBI Number or Business License No.
Washington State Contractor License Number (Contractors only)
Area of Expertise
DEBARMENT AFFIDAVIT (must be notarized)
Please click the button below to be sent a copy of your Small Works Roster Application, along with the Debarment Affidavit to be printed, filled out and notarized.
Should be Empty: