Contractor Registration Form

Contractor Registration Form

Please complete this form in full to register for the Illinois Works Bid Credit Program. If approved, you will receive an email notification with your Bid Credit Account number and unique log in information. If updates are needed, you will receive an update request form. If you have any questions, please contact CEO.BidCreditProgram@illinois.gov.

Company Name*

Please enter full corporate name as registered with State of Illinois.

Primary Contact First Name*

Primary Contact Last Name*

Primary Contact Title*

Primary Email Address*

It is highly recommended that a service account email address be used to set up your account, eg. info@companyname.com.

Secondary Email Address

Primary Phone Number*

Phone

Secondary Phone Number

Phone

Federal Employer Identification Number (FEIN)*

Please input 9 digits only, omitting the dash.

Street Address*

Please enter business or corporate mailing address.

City*

State (abbreviation)*

Please enter the abbreviation ONLY.

Zip Code*

Staff Hired in IL?*

Yes

IL Street Address*

If the business or corporate mailing addressed entered above was outside the State of Illinois, please provide the address of your location within the State of Illinois.

IL City*

IL State*

Please enter the abbreviation ONLY.

IL Zip Code*

Construction Trade*

Please select all that apply.

Select or enter value

If other, please explain:

Is your company signatory to a union?*

Yes

Union Affiliations*

Please select all that apply to your business:*

Please select certified if you have been certified by the State of Illinois Commission on Equity and Inclusion (CEI) and hold an active certificate.

If other, please explain:

By submitting this form, I give my consent for my Company information to be published on the Illinois Works webpage. The Illinois Works will publish monthly a Bid Credit Registry listing all participating contractors/subcontractors, their contact information, address, construction trade, company size and company certifications. This information will help both contractors and subcontractors find other contractors and subcontractors to partner with for future projects.*

Please check the box below to acknowledge

By submitting this form, I certify to the best of my knowledge and belief that the form is true, complete, and accurate and that any false, fictitious, or fraudulent information or the omission of any material fact could result in the immediate deactivation of my Bid Credit Account. I understand that submission of false, fictitious, or fraudulent information could cause Illinois Works to bar me from participating in the Bid Credit program and may suspend me from bidding on or participating in any public works project.*

Please check the box below to acknowledge

Send me a copy of my responses

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