CONSTRUCTION CONTRACT ENTERED INTO BEFORE THE                                              Wisconsin Department of Revenue
                                                                                                               PO Box 8949
EFFECTIVE DATE OF A NEW OR ADDITIONAL COUNTY OR                                                 Madison WI 53708-8949
CITY TAX

Refer to the Tax Rates common question for a listing of the                  Identification of Written Contract
applicable counties, cities, and effective dates.             Descriptive Name of Contract

Who May Use This Certificate: A contractor may use this 
                                                              County or City of Job Site        County or City Tax Effective Date
certificate to purchase building materials without a new or 
additional county or city tax, if:
                                                              Date of Bid                       Date Contract Signed
(1)  The contractor entered into a written contract or made 
a  formal  bid  before  the  effective  date  of  a  new  or 
additional county or city tax to construct, alter, repair     Date of Prime Contract
or improve real property for another person; 

(2)  The written contract is for a fixed price that cannot be 
changed or the formal written bid cannot be altered or 
withdrawn; and

(3)  The building materials purchased on or after the effective date of a new or additional county or city tax are affixed and 
made a part of real property in fulfilling such written contract or formal written bid.

The undersigned contractor hereby claims that it meets the 3 conditions listed above and is entitled to purchase building 
materials without a new or additional county or city tax under this certificate from                                             .
                                                                                                (Seller)
Such building materials are to be affixed and made a part of real estate in the Wisconsin construction contract described 
above. The undersigned contractor was obligated to perform this contract on                             pursuant  to  a 
                                                                                          (Date)
written contract, which was entered into or a formal bid which was made before the effective date of a new or additional county 
or city tax in                    . In the event any such building materials are used for any purpose other than being 
                   (County/City)
affixed to real estate in the above contract, the undersigned contractor understands that they are required by law to report and 
pay the applicable county or city tax on such building materials if used in a county or city which adopted a new or additional 
county or city tax.

Name of Contractor                                            Address of Contractor

Signed By                                                     Title                                     Date

NOTE:  The contractor must provide the seller with this completed certificate if building materials are to be purchased without 
a new or additional county or city tax. This certificate shall not apply to sales of tools, machinery and equipment used by 
contractors. Misuse of this certificate by the seller or contractor, or other agents may constitute a misdemeanor.

                                  Sellers must retain this form as a part of their records.

S-207CT-1 (R. 1-24)