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WTBA Membership Application

Membership Class*

Contractor Members are engaged in the construction of highways, public airports or other transportation infrastructure.

Associate Members are manufacturers/sellers of transportation construction supplies or services, engineering and design professionals and other professional services firms.

Company Information

Company Name

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Website*

Email*

Phone*

Fax

Number of Employees

Please describe your company's products and services*

Company Logo

High quality, 300 DPI minimum

Accepted file types: jpg, png, pdf, eps, ai, Max. file size: 128 MB.

Agreement*

The undersigned hereby applies for membership in the Wisconsin Transportation Builders Association on behalf of the company named herein and accepts and agrees to the following terms of membership:

Dues & Assessments

Dues

Member dues are $500 annually, payable by January 10th of each year or at the time an application for membership is approved.

Assessments

Additional assessments are paid by Prime Contractors — WTBA Contractor Members who are chosen as low bidders on contracts for transportation projects let by WisDOT or other Wisconsin public entities when financed in whole or in part by the State of Wisconsin or federal funds attributed to Wisconsin. Transportation project means highway, bridge, bicycle/pedestrian facility, airport, mass transit or railroad project. The amount subject to assessment is equal to the sum of state funds, federal funds attributed to Wisconsin and any local matching funds.

• First $20 million: 0.25%
• Next $10 million (up to $30 million): 0.15%
• Next $10 million (up to $40 million): 0.10%
• Next $10 million (up to $50 million): 0.05%
• Remaining amount over $50 million: 0.025%

Membership Agreement

Upon approval of this application, the applicant named herein agrees to comply with the bylaws, resolutions and policies of WTBA and to advance the objectives and interests of WTBA. It is further understood and agreed that:

This application will be presented to the Board of Directors for approval. If approved, membership is activated upon payment of dues.

A membership term is the period beginning December 1 and ending November 30. Membership renews automatically unless cancelled no later than 30 days after the start of the subsequent membership term.

Fees are assessed to prime contractors on transportation project contracts beginning the date membership begins through the end of the membership term. Assessments paid within 90 days of invoice receive a 5% discount.

Dues and assessments are deductible business expenses for federal income tax purposes. Contributions or gifts to the association are not deductible as charitable contributions.

Name*

First Last Title

Date*

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