Company Name*
GST #* PST #
HST#QST#
Position Held
Locations* Number of Years In Business Please Select 0-5 Year 6-9 Years 10-15 Years 16+ Years
Number of Technicians*
Please include pricing in Canadian Dollars (CAD)
Sub Rate ($/hr)* Travel Rate ($/hr)*
Regular Rate ($/hr)* Mileage Rate ($/km)*
Hours of Business*
Days of operation: Mon. Tues. Wed. Thurs. Friday Sat. Sun.*Are you willing and able to provide storage for equipment if needed? YES NO*
What distance are you willing to travel for a job (km)?* What is the average timeline for notice required to perform service calls?*
What cities/locations you are willing to perform service?
Is you business registered through WCB? YES NO* Do you have access to a lift? YES NO* Do you/your employees have Aerial Work Platform Certifications? YES NO* Is your company and/or your employees insured? YES NO*
Cable Termination UTP STP Coaxial Video TV Mounting Projectors Digital Signage Control Systems Crestron QSC Symetrix Audio Distributed Audio (70V) Direct Audio (4/8 Ohm) Sound Masking Security CCTV/IP Camera Systems Card Access Networking LAN Configuration
Please list other services your company provides that were not listed above ie. control systems, etc.
Printed Name Title
Signature* Date* Thank you for completing our subcontractor account set up form. We look forward to working alongside you in the future. Please remember to provide Hillman AV with supporting WCB and Insurance documentation.*