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Contractor Development and Bonding Program (CDABP)

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Online Enrollment Form

Program(s) you are enrolling in:

** We recommend you enroll with each sponsor for efficiency.

Participant Information

Company Information

Type of entity

Business Relationships

Do you currently have bonding?
In the past three (3) years, I have BID on Public Works projects as a:
In the past three (3) years, I have been AWARDED on Public Works projects as a:

Certification, Ethnicity, and Union Information

Certification Status
Is your firm signatory to a union?
Certifed As:
Certifed As:
Certifed As:
Certifed As:
Certified With
Ethnicity (optional)

Authorization

I/WE AUTHORIZE AND CONSENT TO MERRIWETHER AND WILLIAMS INSURANCE SERVICES, INC. (MWIS), AS BOND ASSISTANCE PROGRAM ADMINISTRATORS, AND/OR SURETY/BANK OBTAINING INFORMATION FROM THIRD PARTIES, INCLUDING BUT NOT LIMITED TO, CREDITORS, BROKERS, SURETIES, INSURERS, BANKS, OR ANY INDIVIDUAL(S) OR INDIVIDUAL REPRESENTATIVE(S) OF ANY FIRM(S), ENTITY (IES) OR ORGANIZATION(S) RELATED TO THE EVALUATION OF MY/OUR QUALIFICATIONS. I/WE RECOGNIZE THAT TO ENSURE THE EFFECTIVENESS OF THE ENROLLMENT PROCESS, SUCH INDIVIDUALS MUST BE ABLE TO SPEAK FRANKLY AND OPENLY. ACCORDINGLY, I/WE HEREBY FULLY AND UNCONDITIONALLY RELEASE AND DISCHARGE THE PARTIES FROM ANY CLAIM OR LIABILITY RELATING TO INFORMATION PROVIDED IN CONNECTION WITH THE PROCESSING, INVESTIGATION AND EVALUATION OF OUR APPLICATION OR ENROLLMENT DOCUMENTATION.

Your form has been submitted.

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