Village of Worth

7112 W. 111th Street

Worth, Illinois 60482

Phone: (708) 923-7507           Fax: (708) 448-1193

 

Contractor’s Registration

 

Business Name:__________________________________________________

 

Business Address:________________________________________________________

 

City: ____________________________State:_________________Zip:_____________

 

Business Phone: _________________________________________________________

 

Owner’s Name:__________________________________________________________

 

Owner’s Address:________________________________________________________

 

City:_____________________________State:_________________Zip:____________

 

Owner’s Home Phone:____________________________________________________

 

Type of Contractor:______________________________________________________

 

RESIDENTIAL                                    COMMERCIAL

 

Please turn in the following with this application: Certificate of Insurance, $10,000 Bond ($25,000 Bond for sign contractors) and a $110.00 registration fee.

FOR OFFICE USE ONLY

 

STICKER #__________________

 

ACCOUNT #_________________

 

CERTIFICATE OF INSURANCE___________YES_____________NO

 

BOND POSTED_______YES_______NO

 

FEE:_________________RECEIVED BY:______________________

                                                                         (INITIALS)

 

 

LICENSE EXPIRES DECEMBER 31st OF EACH YEAR

 
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Attention Landscapers and Tree Removal Companies:    Any yard waste that you are involved with must be removed by your company.  Leaves may be bagged and left for the waste service to pick up.  The Village of Worth DOES NOT pick up any yard waste left by contractors.