Subcontractor Sign Up
Company
*
Business Name
Website
www.example.com
Email
*
example@example.com
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
-
Area Code
Phone Number
Owner Name
*
First Name
Last Name
Owner Cell Phone Number
*
-
Area Code
Phone Number
What cities and states do you currently service?
*
Do you provide 24 hour emergency service?
*
YES
NO
Please choose your service type:
*
Janitorial
Strip & Wax
Tile & Grout Cleaning
Carpet Cleaning
Porter Service
Parking Lot Attendant
List all accessible equipment
*
Do you have USD $1 Million Liability Coverage?
*
YES
NO
Do you have Workers Compensation Insurance?
*
YES
NO
Any comments or questions:
Please tell us how you heard about Sani-Jan Cleaning:
*
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