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CONTRACTOR AFFIDAVIT
Leave This Blank:
STATE OF VIRGINIA
CITY OF RADFORD
I do not need a State Contractors License as I will not perform any work valued at $1,000 or more per project or the total value of all projects in a twelve month period does not equal or exceed $150,000; nor will I perform any landscape irrigation or water well work.
Contractor - Please Print Name
Contractor - Signature
Date
This Affidavit was acknowledged before me on the _____ day of __________, 2015.
Being first duly sworn on oath according to law, disposes and says that he/she has read the foregoing Affidavit and that the matters stated herein are correct.
Notary
My Commission Expires
Cathy Flinchum
Commissioner of the Revenue
619 Second Street, Room 161
Radford, VA 24141
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