Servicing Lenoir, NC and surrounding areas.

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Subcontractor Application Form

1. Company Information

  • Legal Business Name: ____________________________

  • DBA (Doing Business As), if applicable: ____________________________

  • Business Structure: ( ) Sole Proprietor ( ) LLC ( ) Corporation ( ) Partnership

  • Company Address: ____________________________

  • Website URL: ____________________________

  • Federal Tax ID (EIN): ____________________________

2. Primary Contact Details

  • Contact Person Name: ____________________________

  • Title/Role: ____________________________

  • Phone Number: ____________________________

  • Email Address: ____________________________

3. Trade & Capabilities

  • Primary Trade / Specialty: ____________________________

  • Secondary Trades: ____________________________

  • Geographic Service Areas (Cities/Counties): ____________________________

  • Years in Business: __________

  • Current Crew Size: __________

  • Preferred Project Size Range ($): ____________________________

4. Licensing & Insurance

  • State Contractor License Number: ____________________________

  • License Expiration Date: __________

  • Can you provide a Certificate of Insurance (COI) naming us as additionally insured?
    ( ) Yes ( ) No

  • General Liability Carrier & Policy Limit: ____________________________

  • Workers' Compensation Carrier: ____________________________

5. References & Past Projects

  • Recent Completed Project (Name & Brief Description): ____________________________

  • Professional Reference 1 (Name, Company, Phone): ____________________________

  • Professional Reference 2 (Name, Company, Phone): ____________________________

6. Required File Uploads

  • Upload Completed W-9 Form

  • Upload Certificate of Insurance (COI)

  • Upload Trade License / Certifications

7. Acknowledgment & Authorization

  • "By submitting this application, I certify that all provided information is accurate and true to the best of my knowledge. I authorize [Your Company Name] to contact the references provided above to verify our qualifications."

  • Authorized Signature (Type Name): ____________________________

  • Date: __________