WVDOT, Division Of Highways
Contract Administration Division

 

LETTING DATE: _____________________________ 

FEDERAL EMPLOYER'S IDENTIFICATION NUMBER:  ____________________________________

CONTRACTOR ____________________________________________________________________________________ 

BILLING ADDRESS _________________________________________________________________________________ 

_________________________________________________________________________________________________
Type of Contract Documents: PRIME CONTRACTOR ______ SUB-CONTRACTOR ______ SUPPLIER ______ 
IF REQUESTING DOCUMENTS 
VALID FOR BIDDING PURPOSES PLEASE SUBMIT:                 UNCOMPLETED WORKLOAD $________________________
Documents: MAILED ________ PICK-UP _________ Please FAX requested order to:
(304)558-2815

Invoicing will be through the WVDOT Division Of Highways, Finance Division, the following month.
Call
No 
Project Numbers 
      Federal                             State
 County Plan
Qty 		Proposal
Qty 		X-Section
Qty
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SHIPPING ADDRESS _______________________________________________________________________________ 

_________________________________________________________________________________________________ 

ORDER REQUESTED BY _______________________________________ 
FAX:       ____________________________ 
PHONE: ____________________________