Licensed Contractor Form – Big Boulder Lake

Contractor Company Name *

Contractor Contact Name *

First

Last

Contractor Contact Phone Number *

Building and Unit # where work is being completed: *

Unit Owner Name *

Copy of Work Permit *

Click or drag a file to this area to upload.

Please upload your copy to this form

Workman’s compensation Insurance declaration page *

Click or drag a file to this area to upload.

Please upload your copy to this form

Declaration page of Liability Insurance *

Click or drag a file to this area to upload.

Please upload your copy to this form

Midlake board of directors approval *

Click or drag a file to this area to upload.

Scope of work to be completed: *

Start Date: *

Completion Date: *

Authorized Signature *

List of contractor rules goes here.