New-Hab Inc. Property Preservation, Lansing, MI

517-485-1011

Vendors

If you are a contractor who wishes to work with our company, please fill out the information below.

Company Information:

Your Name:

Company Name:

SSN:

Federal Tax ID:

Address

City:

State:

Zip:

Daytime Phone:

Cell Phone:

Fax:

Email Address:

Liability Insurance Company:

Liability Insurance Expiration Date:

# of Employees

% of Work done by Owner

Do you require Drug Testing for Employees?

Yes No

Do you require Background Checks for Employees?

Yes No

Have you previously worked for New-Hab, Inc. before?
Yes No

If yes, provide additional information that may be helpful to us:

Do you acknowledge and understand that if you are retained by New-Hab, Inc., you will be working as an independent vendor. The completion of this application shall not be construed as creating an employee/employer relationship between you, your company or your employees and New-Hab, Inc. and its affiliates; that it is the intent of the parties that every vendor/contractor performing work for New-Hab, Inc. be and remain an independent vendor/contractor and not employees of New-Hab, Inc.; and that no vendor has the right to receive work from New-Hab, Inc.; and that work shall be awarded based on performance which is determined on an individual basis?
Yes No

Have you or your company ever been barred from completing HUD work?
Yes No

Do you understand that if work is not completed according to guidelines, New-Hab, Inc. will correct your invoice to guidelines.
Yes No

Property Preservation:

I will charge $ for trip charges.

I am a Licensed Contractor.
Yes No

License # State of License:

Please choose the category and subcategory of the type of work that you are interested in doing. Note: you can choose to do more that one type of work for New-Hab, Inc.

Lawn Services	Debris Removal	Housekeeping
Property Preservation	Demolitions	Health/Hazards Removal
Repairs/Estimating	Minor Repairs	Evictions
Inspections	Vehicle Removal	Miscellaneous
Major Repairs

New-Hab, Inc. requires photos for all services, but does not reimburse for photos.

I understand that I must submit photos of each job I perform. I will not be paid until I have supplied Before and After photos.
Yes No

I am able to use the Internet (Receiving work requests, inspections, sending results, photos, etc.
Yes No

Areas Covered:

Please list the areas (Zip Code Range, Counties, Cities) that you work in:
(Example: 48248-48300, 48089, 48045)

Additional Information

Please supply us with three business references, companies that you have provided the same services for. If you have any questions please contact us.

Name: Phone: