Market Recovery Grant Request Form

Contractor Name*
Person Making Request*
First Last
Contractor Address*
Street Address Address Line 2 City
Phone*
Fax
Email*
Project
Project Name*
Prevailing Wage*
- No
- State
- Federal
- Unknown
Project Address*
Street Address Address Line 2 City
Project County*
Scope of Work*
Short description of work
Architect*
Project Architect Architect Contact Name Architect Phone
Owner*
Project Owner Owner Contact Name Owner Phone
Construction Manager*
Project Manager Manager Contact Name Manager Phone
General Contractor(s)*
General Contractor(s) General Contact Name General Phone
Bid
Bid Date*
MM slash DD slash YYYY
Bid Time*

: Hours

Minutes

AM/PM
Bid To*

Architect / Owner / General
Estimate Start Date*
MM slash DD slash YYYY
Estimate Completion Date*
MM slash DD slash YYYY
(Total) Electrical Bid*
Material Cost*
Labor Cost*
Number of Apprentices on Project*
If Residential, how many units
Other Contractors Bidding*
Contractor Name Union / Non-Union / Unknown
Notes / Job Description
An email will be automatically sent to the address you provided. Submission of this form does not imply that the Target will be fulfilled. Once we review the form we will contact you directly. Send any questions to mrp@ibew292.org or call 612-379-1292 ask for the Market Recovery Program Director.
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Project

General Contractor(s)	General Contact Name	General Phone

Contractor Name	Union / Non-Union / Unknown