Contractor Staging Request

Requestor Information

Company Name:*

Requestor Name:*

First Name

Last Name

Company Address:*

Address Line 1

Address Line 2

City

State

ZIP Code

Country

Company Phone Number:*

Company Email:*

Project / Services Information

Project Name:*

Location(s):*

Please be as descriptive as possible when indicating locations for where construction is taking place. (i.e. building, streets, lots etc.)

Number of Spaces in the Staging Area Required:*

1,2,3...

Staging Area Layout Diagram & Project Information:*

No File Chosen

File uploads may not work on some mobile devices.

Project Start Date:*

Project End Date:*

LSU Project Manager Contact Name:*

LSU Project Manager Contact Number:*

LSU Project Manager Contact Email:*

Description of Service:*

Please provide a brief description of the service you will be providing the university.

Billing Information

Billing Contact:*

First Name

Last Name

Billing Address:*

Address Line 1

Address Line 2

City

State

ZIP Code

Billing Contact Number:*

Billing Contact Email:*

Method of Payment*

Please be advised that their will be a 2.5% processing fee included on all credit card payments.

I authorize that all information provided on this form, including any and all personal data or financial information, may be shared with LSU Parking & Transportation Services to process the Contractor Staging request. This data will be securely retained for a period of one to five years. To learn more about privacy at LSU, please see the LSU Privacy Statement.

Acknowledgment*

I Agree