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Contractor Application

All information collected by The Repairmen, llc. will not be given, sold or distributed to anyone.  We completely respect your privacy.  The information listed on The Repairmen will be the following:  General business information, Company profile, Accreditations, Yes- No or N/A for insurance and amount, Yes-No or N/A for license and state of license,  Years of experience, and customer reviews.  At anytime you may have us remove all your information from The Repairmen, llc.

Please fill out the application, the more information completed the quicker we can get you in the network, we will contact you upon review of you application.   If you would like more information about The Repairmen just add your name and phone number and submit application or email us at info@therepairmen.net

Business Information

        First Name :      Last Name :

Company Name :

            Address :

                                

  Business Phone :   Contact Phone :

     Email Adress :   Website :

 

Service Category : (Select up to 2 Categories)    

                               

 

Service Areas : (Select up to 5 areas)    

                                 

Business Tag line :

Company Profile :

Years of experience :

How long have you been in business?

 

Certifications :

Insurance Information :

General Liability - Company :  Amount :  Exp. Date : /

Workmen Compensation :  Yes  No N/A

License Information :

Licence with City : Yes  No

Trade Licence:   Type :   State : Exp. Date: /

References :

                1.  Name :     Phone :

                2.  Name :     Phone :

                3.  Name :     Phone :

 

                                                                                        

 

 

 

 

 

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