GUCA Utility Contractor Dues Payment Renewal

Utility Contractor Membership

Utility Contractor Definition: A company that performs utility contracting as their primary means of business as defined by the Georgia Utility Contractors Licensing Law. Please view the type of work drop down designations below for examples.
Date*

MonthDayYear
Date
Type of Membership*
Type of Work*
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
Please list the exact name as you wish it to appear in a directory search.
Company Name*
Please list the exact name as you wish it to appear in a directory search.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Company Phone*

Area CodePhone Number
Website
Main Contact*

First NameLast Name
Title
Cell Phone

Area CodePhone Number
E-mail*
Additional Contact
Recruited by GUCA Member:

Full NameCompany
Utility Contracting Volume / Dues Amount*
prevnext( X )
$0-$2 Million Annual Volume$1,200.00

$2-$5 Million Annual Volume$2,400.00

$5-$10 Million Annual Volume$3,200.00

Over $10 Million Annual Volume$3,800.00

Total $0.00
Signature*
Signature date*
Enter the message as it's shown*
Should be Empty: