Urban Redevelopment Authority
Application for Contractor Registration Name of Firm
Address of Firm (No P.O. Boxes)
Type of Entity
Business Phone
Emergency Contact
Contact’s Phone #
Are you currently registered to do business in the City of Pittsburgh?
If yes, provide City Tax ID number
Doing business with URA requires proof of insurance at time of contracting. It is NOT necessary to carry insurance to be eligible for the slate of contractors.
Are you currently insured?
If yes, please provide the following:
Insurance Carrier
Insurance Policy No.
Insurance Amount (liability) $
Workman’s Comp. Policy No.
Federal or State Employer No. OR Social Security Number
MWBE Are you an MBE or WBE? If MBE or WBE, are you certified? Name of certification and/or certifying entity: Owner(s) of Business or Officer(s) of Corporation Name and Title (if Corporate Officer) Address City/State Zip Phone
Have any principals done, or are currently doing business using any other names? If yes, provide ALL:
PA Home Contractor License # Email Address (if applicable)
Have you done work with the City of Pittsburgh or URA in the past 10 years?
What is your firm’s capacity? (#full time employees) Job classifications: (carpenter, laborer, etc) Please provide the range of contract amount you would be willing and able to engage in a contract for: Minimum project amount? $ Maximum contract amount: $ Do you have existing financial capacity to begin projects immediately? If Yes, at what contract amount?: $
Select ALL Services you provide directly and/or subcontract and would be interested in/ willing to engage in contracts with URA or our clients for: You provide Sub Out You provide Sub Out Healthy Home Systems:
Radon System Mold Removal & Remediation Asbestos Removal Lead Abatement Energy Audit / Home performance
General Building Trades Carpentry Electrical Flooring General Labor Drywall Roofing Masonry Siding Doors & Windows Painting
Alarm, Monitoring & Security Systems Basement Sealing Bituminous Paving Chimney Repair & Construction Clean‐Out / Debris Removal
Commercial Façade Demolition Disaster Recovery (Flood / Fire) Environmental Waste Remediation Excavation Exterior Steps Fencing Land Surveying Landscaping Paving Pre‐Cast Residential Façade Retaining Walls River Salvage Sidewalk repair Streetface Tree Removal Towing Utility Installation Other: Specializations: (French drain, Historic renovation, green infrastructure, solar paneling, eg)
Either state prevailing wage rates or federal Davis‐Bacon wage rates may apply to project funding. Does your firm have experience with this? Are you willing to complete wage rate projects?
Have you included your affidavit of debarment? Have you completed and included your W‐9? Are you bonded?
SIGNATURE OF APPLICANT _______________________________________________________________ DATE: ________________________