Contractor Application

Please fill out the information below and we will contact you as soon as possible
Complete the following: (check as many as applies)
General Contractor/Home Builder Flooring/Floor Covering/Tile
Remodeling Contractor Handyman & Repair
Light Commercial Heating/Air Conditioning/Mechanical
Concrete/Masonry Interior Trim/Decorating/Finish
Cabinets/Counter Tops Painting
Drywall/Plaster/Stucco Plumbing
Decks/Garages/Fencing Roofing/Gutters/Chimneys
Doors/Windows/Siding Hot Tubs/Sunrooms/Special Additions
Electrical Landscaping/Yard Care
Excavation/Demolition/Cleanup/Paving Home Inspection/Design & Plans/Appraisal/Survey
Fire Restoration/Water Damage/Renovations Other:
Special Construction - Pole, Steel, Mobile Homes
 
Company:
Owner's Name:
 
Address:
City/County:
State/Zip:
Phone:
Fax:
Email:
UBI#:
Counties you will work in:
How we select our contractors:
In every area there are contractors that do poor work and contractors that do quality work. We represent contractors who
have a history of quality work backed by testimonials from their customers.
 
We select contractors based on the following criteria:
1.

Contractors are licensed, bonded, and/or insured.
2.
 Contractors have no unresolved complaints with the BBB or current lawsuits filed aganst them
3.
 Contractors pay their materials/suppliers bills.
4.
 Contractors provide testimonies and references from customers verifying that they do quality work.
  If you fit the above profile, please answer the following questions:
1. How long have you been in business?
2. What is your contractor's license #?
3. With which company are you bonded and/or insured?
4. What is your Bond & Insurance #?
5. Please list 4 customer references:
 
Customer Name & Phone:
 
1.
2.
3.
4.
           
6. Do you currently have a website? What is the web address?:
7. Describe your experience and training:
I understand that I am charged for each job referral I accept from Safe Contractor Referrals, Inc. (SCR).
I understand that to receive job referrals I must have a phone and it is my responsibility to keep SCR informed of any changes.
I authorize SCR the right to contact appropriate parties to verify the information I provided on this application.
I verify that the above information is accurate and true.
Full Name:
Title:

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