Vendor Application - Flood Management Services

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Vendor Applicationrphebus842014-10-03T03:44:40-07:00

Vendor Application

Please make sure you fill out the following form completely before hitting the “submit” button. Please note that if you leave this form before completion your information WILL NOT be saved. You will have to start over.

Step 1 of 7 - Company Information

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Company Information
Today's Date:*
Date Format: MM slash DD slash YYYY
Company Name:*
Contact Name:*
First Last
Company Address:*
Street Address City State ZIP Code
Phone #:*
Fax #:
Cell #:
Email Address:*
Website:
Type of Business:*
Federal ID:*

Experience
How many years has your company been in the industry?*
What is the current size of your field operations?*
# of employees
What is the current size of your office operations?*
# of employees
Do you use subcontractors?*
- Yes
- No
If yes, how many subs do you use?*
Do you require insurance or background checks on your subcontractors and employees?*
- Yes
- No
What are your business days of the week?*
Please check all that apply
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Weekends
What are your business hours?*
Are you available to work on the weekends?*
- Yes
- No
Do you have computers with internet service?*
- Yes
- No
Do you have the ability to send/receive emails & other info from the field via wireless enabled laptop, tablet or smartphone?*
- Yes
- No
Do you have the ability to scan and email documents?*
- Yes
- No
Do you have digital cameras with a minimum of 4 megapixels?*
(used to take pictures of all work performed)
- Yes
- No
Licenses & Affiliations
Please list all licenses (i.e. Business License, Contractors License, etc.), issuing affiliations and expiration dates:
Business License #:*
Issuing Affiliation:*
Expiration Date:*
Date Format: MM slash DD slash YYYY
Contractors License #:*
Issuing Affiliation:*
Expiration Date:*
Date Format: MM slash DD slash YYYY
Other License #:
Issuing Affiliation:
Expiration Date:
Date Format: MM slash DD slash YYYY
Please list any other license information that may be applicable:
Please list all business organization affiliations:
Companies You Support
Please list the top companies you support by volume:
Company:*
# of Years:*
Volume:*
Company: