RENT ME FLORIDA VENDOR APPLICATION FORM
A $99.00 application fee is required for each contractor/vendor. A national background check will be processed. Each contractor/vendor must provide a copy of their service license and drivers license.
* Required
Applicant:
* Full Name [Include all names you use[d]:
* Home Address:
* Previous Address:
* Personal E-mail:
* Social Security Number:
* Birth Date:
* Federal Tax Id Number:
* State License Number:
Company Information:
* Name of Company:
* Company Phone Number:
* Company Fax Number:
* Mailing Address:
* Company E-mail:
* Areas of Service:
* Types of Service:
* Basic Fees:
* Number of Years in Business:
* Number of Employees:
* Do you run a background check on your employees: Yes No
* Are you insured? (Please fax certificate of insurance) Yes No
* Business References:
* Personal References:
Have you ever:
* Been Sued? Yes No
* Been Convicted of a crime? Yes No
* Been in jail? Yes No
Explain any "yes" answer to the above questions:
By initialing below, I certify that all the information given above is true and correct and understand that my agreement may be terminated if I have made any material false or incomplete statements in this application.
Initials of applicant:* Date: * (dd/mm/yyyy)