Vendor Application

Part 1: Contact Information

Business Name

DBA

Business start date

Month

Day

Year

What is your primary business?

Website

Business owner name

Office phone number

Alternate/cell number

Owner Email

Point of Contact (POC)

POC Phone

POC Cell

POC Email

Physical Address Street 1

Physical Address Street 2

Physical Address City

Physical Address State

Physical Address Zip Code

Mailing Address Name

Mailing Address Street 1

Mailing Address Street 2

Mailing Address City

Mailing Address State

Mailing Address Zip Code

Part 2: Company Experience/Capabilities

Have you worked for Property Preservation Companies Before?

If yes, please list the names

One item per line

What is your current volume of work?

How much more work do you have the ability to handle?

Number of W2 Employees at your Company

Do you hire sub-contractors?

How many sub-contractors do you have?

Are you a licensed Contractor?

(Please note that you do not have to be a contractor to work for us. However, for certain specialties such as "Roof Repair" we would require a licensed roofing contractor)

Contractor License

(Please submit document in one of these file formats: PDF, JPG)

Do you have Liability Insurance?

Liability Insurance

(Please submit document in one of these file formats: PDF, JPG)

Do you have Workmans Comp?

Workmans Comp

(Please submit document in one of these file formats: PDF, JPG)

What Certifications and Licenses do you hold?

One item per line

What Professional Associations do you belong to?

One item per line

Please identify specialties

Check off all that apply

What other specialties do you have?

One item per line

What other Preservation services do you provide?

One item per line

What other Repair and Contractor services do you provide?

One item per line

Part 3: Equipment / Software

Generator

Compressor

Laptop/Computer

Internet Access

Digital Camera

Do you have a phone capable of sending photos from the job site?

List other equipment/technology used by your company

One item per line

Do you use work order management software?

Do you use Microsoft Office Excel?

What other tools do you use?

One item per line

Part 4: Service Area

Do you serve Florida?

What other US states do you serve?

Please list the states and corresponding counties where you serve (One item per line)

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Vendor Application

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