CITY OF CONWAY, SC

SUB-CONTRACTOR ROSTER

General Contractor Instructions -1 7complete all re�ested information and return to building department 2 weeks prior to requesting C/O.

2 !Sub-contractors contract value must be shown on roster card.

= T T General Contractor: _ l _ 1

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ProJectName: I -Project Address: I _

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Job Supervisor: I Cell Phone 1 c------,----------t

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CONTRACT VALUE -if UPDATE REQUIRED � Yes -� No __

1 jDATE NOTIFIED MAIL ADDRESS $ loATE PAID

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- i PEST CONTROL T -� - Bus1N1ss LICE_N_S-+E -O-F -FI_C _E _u_sE�O -NL- Y::::::::::::: COMPANY NAME-f- ± CONWAY BUS. LIC. # CURRENT ---

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�Yes I- N� CONTACT NAME --- RENEWAL REQUIRED Yes No TELEPHONE CONTRACT VALUE UPDATE REQUIRED Yes No

FAX NUMBER -

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+ DATE NOTIFIED

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DATE PAID E-MAIL ADDRESS 1

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___!USINESS LICENSE OFFICE USE ON_L Y�---J COMPANY NAME CONWAY BUS. LIC. # CURRENT Yes No CONTACT NAME

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RENEWALREQUIRED Yes _-,_ No TELEPHONE I CONTRACT VALUE UPDATE REQUIRED Yes No

FAX NUMBER I j � DATE NOTIFIED +--MAIL ADDRESS 7 _ _ _ _

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JI ROOFING

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---J- BUSINESS LICENSE OFFICE USE ONLY

COMPANY NAM� CONWAY BUS. LIC. # I

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- CURRENT __L ---t- Yes No CONTACT NAME ---

---+--- RENEWAL REQUIRED Yes No

TELEPHONE - -

CONTRACT VALUE - UPDATE REQUIRED -Yes - No-� - .,-----------,- - -

FAX NUMBER $DATE NOTIFIED

MAIL ADDRESS --+--

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-----t-DATE PAID I E-MAIL ADDRESS--- - --

-[ Custo_ m_e�r _N _u_m_ b_ e_r -+---

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t J ___ � BRICK/BLOCK MASON BUSINESS LICENSE OFFICE USE ONLY

COMPANY NAME J �j CONWAY BUS. LIC. # 1 J

CURRENT -- Ye-s-�I

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I UPDATE REQUIRED i Yes r--= No __

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E-MAIL ADrRE� T -1 I _ -----r Customertumber --. _