Neighborhood Vitality Grant Masonry Contractor Registration

This application is required for participation in the Neighborhood Vitality Program.

A valid copy of the certificate of insurance and state-issued identification must accompany the application for processing. Failure to submit the required documentation may result in a delay/denial of program participation. Registration to participate in the Neighborhood Vitality Program as a contractor is valid for one year from the application submission date.

Questions regarding the registration process should be emailed to registrations@addisontx.gov

General Contractor and Trade registrations must be completed online via the CSS Portal. prior to using this form.

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Company Name *

Enter the name of the company

Company Owner Name *

Company Mailing Address *

Company Email *

Company phone number *

Name of State License Holder *

TSBPE/TDLR Registration Number *

Mailing Address for State License Holder *

Office phone number *

Cellphone number of License Holder *

Email Address *

Insurance Company Name and Address *

Policy number *

Upload Certificate of Insurance *

Upload a copy of the current certificate of insurance
Files must be less than 2 MB.
Allowed file types: jpg jpeg pdf.

Coverage Type *

Name of Insured *

Town of Addison Contractor Registration Number *

Acknowledgement *

I hereby certify that the above information is true and correct to the best of my knowledge, and I understand that I am responsible for the work performed by the Company using the above-listed license; and that all Federal, State, County, and City laws must be adhered to in the performance of any work within the Town of Addison. I understand that providing this document will act as my permission to be submitted for consideration as a qualified tradesman for the Neighborhood Vitality Program and my information may be provided for public use

Neighborhood Vitality Grant Masonry Contractor Registration

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