VENDOR APPLICATION
Company Name
Date
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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
2 digit month, 2 digit day, 4 digit year
Date
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 Laptop?
YES
NO
Do You have a mobile device?
YES
NO
Do you have access to the Internet/ e-mail
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
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