Form Center

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.
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:


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

    This field is not part of the form submission.

49. Submit Submit and Print

* indicates a required field