4. E-mail Address:
5. Phone Number: Format: (###) ###-####
6. ZIP Code:
7. Metro/Areas Covered:(e.g. Miami, Ft . Lauderdale, etc.)500 character limit
8. Primary Capability: (Please select only one.)
9. Additional Capabilities:(To select more than one, hold down the ctrl key and left click)
10. How did you hear about us?
11. If other, please provide a brief explanation:
12. Do you have at least one year experience completing inspections, property preservation, estimates and repairs?
13. Do you use employees or 1099 / subcontractors to complete work (or a mix of both)?
14. How many employees and/or subcontractors do you utilize?
15. Do you have a quality control program?
16. If yes, please provide a brief description of your program: 500 character limit
17. Have you or your company ever been barred from completing HUD or investor agency work?
18. Are you or your company involved in any current litigation related to performance of property preservation and/or protection services?
19. Have you ever been convicted of a crime?
20. If yes, please provide a brief explanation:500 character limit
21. Do you currently have any active non-compete agreements?
22. If yes, please provide the expiration date:
23. I understand that, prior to performing work for Independent Securing Services, I will have to submit to a background check and meet all insurance requirements.
24. I acknowledge and understand that if I am retained by Independent Securing Services, I will be working as an independent contractor?