VENDOR APPLICATION
APPLICANT INFORMATION
Company Name
Date
/
Month
/
Day
Year
Date
Date Picker Icon
Name
First Name
Last Name
Email-Address
example@example.com
Website
Primary Phone Number
-
Area Code
Phone Number
Secondary Phone Number
-
Area Code
Phone Number
Have you worked for a property preservation company?
YES
NO
If yes please list name(s) of property preservation companies you have worked for or are currently working for?
Have you worked for broker or realtor before?
YES
NO
If yes, please list broker(s) /realtor(s) you have work for or are currently working for.
Have you or any of your affiliates applied for work as contractor with A&D Property Services?
Do you have a least $1,000,000.00 in general liability insurance?
YES
NO
If not when can you get it?
Do you have at least $500,000.00 in worker’s comp. Insurance?one
YES
NO
If not when can you get it?
What services dose your company perform? (please be specific)
What counties can you cover? (please be specific)
How long have you been in business?
-
Month
-
Day
Year
Date
Date Picker Icon
What type of vehicle(s) do you have?
Do you have the equipment/tools needed to complete all of your services?
YES
NO
Do you have a digital camera?
YES
NO
Do You have a Laptop?
YES
NO
Do you have access to the Internet/ e-mail/ fax or scanner?
YES
NO
Do you have any employees? If so, how many?
Do you have any licenses? If so, what licenses do you hold?
REFERENCES
Please list three
professional references
.
Full Name
Phone
Full Name
Phone
Full Name
Phone
Email
example@example.com
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