2. Company Name*
3. Contact Name*
5. Phone Number*
6. Email Address*
8. Fax Number
9. Contractor Type*

   1. Prime Contractor
   2. Sub Contractor
   3. Engineer / Architect
   4. Plan Room / Other

10. NOTE:  You MUST select "Prime Contractor" or "Sub Contractor" to show on the Plan Holders Lists published on our Out to Bid page at https://www.urbandale.org/185/Projects-and-RFP-Out-to-Bid

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12. 1. Receive an email copy of this form.
13. Email address

    This field is not part of the form submission.

14. Submit

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