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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?: $
