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Subcontractor Pre-qualification Form

Name (required):

Current Address (required):

Home phone number:

Cellular phone #:

Email:

Transportation (choose one):

Number of employees:

Worker's Compensation Insurance? (choose one):

General Liability Insurance? (choose one):

General Cleaning Experience? (choose one):

Floor Care Experience (strip + wax) ? (choose one):

Window Cleaning Experience? (choose one):

Emergency Contact Name:

Emergency Contact #:

Social Security of Federal identification #:

Comments: