Contractor Information Form

Please submit this form and then remit a $50 contractors fee to the City of Brownfield prior to acquiring the permit.

Business Name:
Mailing Address:
   
Class:
   
Authorized Signatures:
 
 
License Number:
Expiration Date:
   
Insurance:

 Note: General Liability (required by plumbers, electricians and mechanical)
  $5,000 Bond (required by builders and irrigators) made out to City of Brownfield
Insurance Company Name: 
Policy #:
Amount on Policy:
Expiration Date: