Construction Contractor Meet-Up Registration
January 26, 2018 - 8:30am-10:30am
CitySpace

REGISTRATION INFORMATION

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* 1. Company Information

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

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* 2. Company Website

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* 3. Brief Description of Services

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* 4. Representative #1 Name

Name

Email Address

Phone Number

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* 5. Representative #2 Name

Name

Email Address

Phone Number

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* 6. Is your company a registered vendor with the City of Charlottesville?

Yes

No

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* 7. Has your company ever had a contract with the City of Charlottesville?

Yes

No

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* 8. Please indicate if your company is registered as any of the following:

Small, Woman- and/or Minority-Owned

Microenterprise

Disadvantaged Business Enterprise

Disabled Veteran-Owned

Other (please specify)