Rainbow Internation of North York - SUB-CONTRACTOR DATA FOR RAINBOW INFORMATION MANAGER

Sub-Contractors Registration
Sub-Contractors DATA FOR RAINBOW INFORMATION MANAGER
Company Name:
AUTHORIZED CONTACT:
Company Discription:		Salutation:
Contact First Name:		Title:
Contact Last Name: *		Home Phone:
Corporations Your Company is Affilliated With:		Emergency Phone:
Corporations Your Company is Affilliated With:		Cell Phone:
Email:
Do Not Call:

BILLING INFORMATION:
Referred By:
Office Phone:		Office Fax:
Assistant Name:		Assistant Phone:
Other Email:		c/o Department:
Building Address:		City:
Province:		Postal Code:
Country:

QUESTION BLOCK - Enter all answers as shown below 1. Are you available 24 Hours? "Yes 24H" or "No 24H" 2. Will you invoice directly to the corporation? "Yes Directly" or "No Directly" 3. How long have you been a contractor of the building? "Contractor for ____#yrs" 4. Do you have WSIB coverage? "Yes WSIB account#____________" or "No WSIB" 5. Do you have Liability Insurance? "Yes Insurance Company ______________ Policy#_________" or "No Insurance"
ENTER ALL ANSWERS HERE

MAILING ADDRESS: If different from above
Street:
City:		State:
Postal Code:		Country:

ADDITIONAL INFORMATION:
Licences and Certificates Held:		Lead Source:
Estimating: Restoration Estimates Price Match in effect for identical scope.
Willing to scope jobs?:		Price Guidelines:
If you know the following information please enter it, otherwise leave it blank.
Portal Application:		Portal Name:

Sub-Contractors Registration