Vendor Requirement Form

Once we have reviewed your submitted information, including the insurance information, we will assess your eligibility as our janitorial vendor. Please be aware that the provision of insurance information is a mandatory requirement, and failure to provide the necessary documentation may disqualify you from our selection process.

We look forward to receiving your complete janitorial vendor package, including all the require insurance information. If you have any questions or need further clarification, please do not hesitate to contact us at (407) 516-0377.

Full Name*

First NameMiddle NameLast Name

Email Address*

example@example.com

Phone Number*

Company Name*

GENERAL LIABILITY INSURANCE

This insurance provides coverage for any bodily injury or property damage that may occur during the provision of your services. The coverage amount should be sufficient to protect our company's interests.

EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL

AGGREGATE PRODUCTS - COMP/OP AGG

$2,000,000 $100,000

$5,000 $2,000,000

$2,000,000 $S/T Gen. Agg.

Upload General Liability Insurance*

Upload Workers' Compensation Insurance: *

This insurance is essential to protect employees in caseof any work-related injuries or illnesses. It covers medical expenses, lost wages, andrehabilitation costs. $1 million coverage required.

Upload Bonding Insurance: *

Bonding insurance offers financial protection against any acts of theft, dishonesty, or property damage committed by your employees while working on our premises.

Important Note:

In order contain a positive customer experience, we kindly request that under no
circumstances, vendors or employees, attempt to contact our customers and charge them for any services provided. This action will be a direct violation of our contract. Please be aware that if this occurs, we will take immediate legal actions. To be our vendor you will be required to sign a non-compete agreement.

Upload W9 and ACH Payment Information: *

Please submit current W9 and ACH PAYMENT information for deposit.

Upload Current Tax Certificate*

Please include current tax certificate that demonstrate your compliance with local,state, and federal regulations.

Upload Certificate of Insurance Naming Us the Name Insured*

Please provide copies of your certificate of Insurance naming us the name insured, along with valid proof of coverage. It is important to note that all insurance policies should be from reputable insurance providers and comply with the legal requirements of Florida jurisdiction. Policies must remain active for the entire length of the contract and will be verified. If there’s a policy lapse, the contract will be terminated effective immediately and prorated payment will be made for work performed on our next pay-cycle.