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

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 
                                                                    County or City of Job Site         County or City Tax Effective Date
this certificate to purchase building materials without the 
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 county or city
tax to construct, alter, repair or improve real property            Date of Prime Contract
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withdrawn; and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 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 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 county or city tax in
                       . In the event any such building materials are used for any purpose other than being 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 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 
the 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. 10-23)