Name *

First Name

Last Name

Work Phone *

(###)

###

####

Cell Phone

(###)

###

####

Are You Licensed And Insured *

Yes

No

Can We See The Work On One Or Two Of Your Recent Jobs?

Yes

No

Are Materials And Labor Charged Together Or Separate In Your Bids?

Together

Separate

Either Way

Do You Give Written Warranties For Your Work?

Yes

No

Do You Use Sub-Contractors?

Yes

No

Are Your Sub-Contractors Licensed And Insured?

Yes

No

Do You Belong To The Better Business Bureau Or Local Chamber Of Commerce?

Yes

No

Have You Ever Declared Bankruptcy?

Yes

No

How Often Do You Communicate With Your Clients During A Job?

Multiple Times A Day

Daily

Multiple Times A Week

Every Other Day

Weekly

Monthly

Never

Do You Clean The Job Site Daily?

Yes

No

Do You Have A Problem With Signing A Lien Waiver?

Yes

No

Name - Reference 1

First Name

Last Name

Phone - Reference 1

(###)

###

####

Name - Reference 2

First Name

Last Name

Phone - Reference 2

(###)

###

####

Name - Reference 3

First Name

Last Name

Phone - Reference 3

(###)

###

####

Date

MM

DD

YYYY

Time

Hour

Minute

Second

AM PM

Email The Following Forms:

Contractors License

W9