Contractor Application
Complete this application and upload the required documents to be considered for PMC membership and work opportunities.
Business Information
Business Name
*
Owner Name
*
First Name
Middle Name
Last Name
Contact Person
*
First Name
Middle Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Website
Facebook Business Page
Business Details
Years in Business
*
Business Type
*
Please Select
Sole Proprietor
LLC
Corporation
Partnership
Do you have employees?
*
Yes
No
Number of Employees
Service Radius (Miles)
*
Licensing & Insurance
Business License Number
*
Trade License Number
*
Insurance Company
*
General Liability Coverage
*
Insurance Expiration Date
*
-
Month
-
Day
Year
Date
Certificate of Insurance
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Business License
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Driver's License
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Tax Information
Do you have a W-9?
*
Yes
No
Upload W-9
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Experience
Years of Experience
*
Describe Your Experience
*
List Three Recent Projects
*
Professional References
Upload Before & After Photos
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Availability
Availability Preferences
*
Full Time
Part Time
Weekdays
Weekends
Emergency Calls
24-Hour Service
Availability Notes
Primary Availability
Please Select
Full Time
Part Time
Preferred Days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Service Coverage
Regular Business Hours
Evenings
Overnight
Emergency Response
24/7 Coverage
Earliest Start Time
Hour Minutes
AM
PM
AM/PM Option
Equipment
Equipment Owned/Used
*
Truck
Trailer
Ladder
Pressure Washer
Lawn Equipment
Generator
Specialty Tools
Other
Other Equipment Details
Truck Type
Pickup Truck
Box Truck
Cargo Van
Dump Truck
Other
Trailer Type
Enclosed Trailer
Open Utility Trailer
Flatbed Trailer
Equipment Trailer
Other
Ladder Type
Step Ladder
Extension Ladder
Multi-Position Ladder
Platform Ladder
Other
Pressure Washer Type
Electric
Gas-Powered
Hot Water
Cold Water
Other
Generator Type
Portable
Standby
Inverter
Commercial
Other
Specialty Tools Categories
Surface Cleaning
Irrigation Repair
Electrical Tools
Hand Tools
Other
Background Questions
Have you ever been convicted of a felony?
*
Yes
No
Has any professional or business license held by you or your company ever been suspended, revoked, or restricted?
*
Yes
No
Have you, your company, or any related business entity ever filed for bankruptcy?
*
Yes
No
Are you authorized to work in the United States?
*
Yes
No
Electronic Signature
Printed Name
*
First Name
Last Name
Signature
*
Date
*
-
Month
-
Day
Year
Date
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