Contractor Membership: Mid-Year / Half-Price
Contractor Definition: A company that performs contracting services that support the underground utility construction industry. Please view the type of work drop down designations below for some examples. Membership dues are currently half price and will cover membership for the remainder of the year.
Date
*
-
Month
-
Day
Year
Date
Type of Membership
*
Please Select
Contractor (CC)
Type of Work
*
Please Select
Asphalt/Concrete
Blasting
Clearing/Grading
Drilling/Blasting
Erosion Control
Hauling/Trucking
Hydro Excavation
Traffic Control
Utility Locating
Other:
Type of Work (Other):
Please Note: ONLY use this section if you selected 'Other' under type of work. Please do not list brands or long descriptors.
GA UCL Number
Company Name
*
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Company Phone
*
-
Area Code
Phone Number
Website
Main Contact
*
First Name
Last Name
Title
Cell Number
-
Area Code
Phone Number
E-mail
*
Additional Contact
Recruited By GUCA Member:
Full Name
Company
My Products
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( X )
$0-$2 Million Annual Volume
$
400.00
$2-$5 Million Annual Volume
$
900.00
Over $5 Million Annual Volume
$
1,250.00
Total
$
0.00
Signature
*
Signature date
*
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