2. This form can be submitted electronically or mailed to: Sierra County Public Works, PO BOX 98, Downieville, CA 95936
4. Contractor Information
6. Business Name
8. First Name
9. Last Name
11. Address1
13. Address2
15. City
16. State
17. Zip
19. Email
20. Phone Number
22. License numbers and types
    Please list all contractors licenses held
24. Essential Requirements for Bidding

    These are minimum requirements to be eligible to perform work as a contractor for Sierra County.

26. Contractors License

    1. Yes
    2. No

    Bidder possesses a valid and current California contractors’ license for the trades for which Bidder is prequalifying under the name presented on this application.
27. General Liability Insurance

    1. Yes
    2. No

    Bidder maintains a commercial general liability insurance policy with a coverage amount of at least $1,000,000 per occurrence and $2,000,000 in general aggregate.
29. Workers Compensation Insurance

    1. Yes
    2. No

    Bidder has a current workers’ compensation insurance policy as required by the Labor Code or is legally self-insured pursuant to Labor Code §3700. If exempt from this requirement because bidder has no employees, bidder will be required to show evidence of exemption issued by the Contractors State License Board.

30. Eligibility

    1. Yes
    2. No

    At the time of submitting this Application for Qualification, is your organization eligible to bid or be awarded a public works contract, or perform as a subcontractor on a public works contract, pursuant to Labor Code §1777.7?
32. A Note about Senate Bill 854:
    In accordance with Senate Bill 854, which became law June 20, 2014, the District will only use registered contractors and subcontractors for public works projects awarded on or after April 1, 2015. All contractors should make sure that they are in compliance. See the Department of Industrial Relations Public Works Funding Fact Sheet on SB854 for more information.
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34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

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