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Re-Register Contractor Information (For Existing Contractors ONLY)

2. Due to upcoming upgrades, the City of Midland is asking all existing contractors to fill out this form to re-register in the new system. DO NOT fill out this form if you are not already registered with City of Midland.

   Due to upcoming upgrades, the City of Midland is asking all existing contractors to fill out this form to re-register in the new system. DO NOT fill out this form if you are not already registered with City of Midland.

4. Are you a General Contractor or a Subcontractor?*

   1. General Contractor
   2. Subcontractor

6. Contractor Type*

10. Company Name*

11. Company Phone #*

13. Company Address*

15. Company City*

16. Company State*

17. Company Zip Code*

19. Contact Name*

20. Contact Phone #

21. Contact Email*

25. Bond #*

26. Bond Insurance Company*

    Please enter the company that holds the bond.

28. Start Date of Bond*
    Start Date of Bond

29. End Date of Bond*
    End Date of Bond

31. License # (Optional)

33. What Type of Work do you Perform?*

    1. Electrical
    2. Plumbing
    3. Mechanical
    4. Irrigation
    5. Other

35. State License #*

36. Expiration Date*
    Expiration Date

38. Master's License #*

    Please enter the license number you hold in your respective field.

39. Expiration Date*
    Expiration Date

41. Driver's License #*

43. Insurance Company Name*

44. Issuance Date*
    Issuance Date

45. Expiration Date*
    Expiration Date

Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

* indicates a required field