2016 ANNUAL PROVISIONAL CONTRACTOR MEMBER LOCAL DUES REPORT Construction work reported should include work performed (1) on federal & heavy, highway & transportation and utility & infrastructure construction work in all counties in Missouri with the exception of the following counties: Jackson, Cass, Clay, Platte and Ray; and (2) on building construction in St. Louis City and St. Louis County and in the following Missouri Counties: Bollinger, Butler, Cape Girardeau, Carter, Dunklin, Franklin, Iron, Jefferson, Lincoln, Madison, Mississippi, New Madrid, Pemiscot, Perry, Reynolds, Ripley, St. Charles, St. Francois, Ste. Genevieve, Scott, Stoddard, Warren, Washington, and Wayne. Please circle the volume of work performed in 2015 and submit with the membership application. Subsequent to the first 12 months of membership this represents the amount for local dues. Total 2015 Volume AGCA National Dues $614.00 Minimum dues for volume to $200,000 1st year - $220.00 $819.00 for volume to $400,000 $1,234.00 for volume to $800,000 $1,539.00 for volume to 1 million $2,154.00 for volume to 2 million $2,668.00 for volume to 3 million $3,493.00 for volume to 5 million $4,106.00 for volume to 8 million $5,031.00 for volume to 10 million $5,646.00 for volume to 15 million $6,935.00 for volume to 25 million $8,140.00 for volume to 30 million $8,420.00 plus $285 per million of volume over 30,000,001 million to 45 million $12,656.00 plus $285 per million of volume of 45,000,001 million to 49,999 million $13,786.00 for volume of 50 million $13,916.00 plus $130 per million of volume in excess of 50,000,001 million We will invoice your company $1,257.00 for the first 12 months of membership ($1,037 local dues and $220. national dues). A 2.7% lobby tax has been included. Retain one copy for your files and return to our office with your application for membership. Email: nvalentine@agcstl.org or Fax: 314-781-2874. If you have any questions, please contact Nancy Valentine, Senior Vice President at (314) 7812356, extension 1003. SIGNED:__________________________________DATE: _____________ ____ COMPANY: St. Louis Office 6330 Knox Industrial Drive, Suite 200, St. Louis, MO 63139-3025 Phone: (314) 781-2356 / Fax: (314) 781-2874 Jefferson City Office 1221Jefferson Street Jefferson City, MO 65109 Phone: (573) 634-3188 /Fax: (573) 634-3510