Subcontractor Application Form

Thank you for your interest in TSI Disaster Recovery Services Inc. Please fill out all information so that we can better evaluate your application. All information marked with and asterics (*) must be filled out in order to complete this form. When your through please click the submit button.

Contact Information
Company Name *
Address Line 1 *
Address Line 2
City *
State *		Zip Code*
Phone *	- -	Fax	- -
Contact Name *		Cell	- -
E-mail *
Website
Business Description
Type of Work *
Employee Type *	Direct Hire Leased Both None of the Above
Business Status (choose one of the following) *
	Small Disadvantaged Business HUBZone Small Business Veteran Small Business Women Owned Business Small Business Service Disabled Veteran None of the Above
Equipment fleet & Description
	Quantity		Quantity
Off Road Trucks		Prentice/Self Loaders
Generators		Bobcat/Skid Steer Loaders
Tub Grinders		Wheel Loaders
Rubber Tire Loaders		Dozers
Excavators		Dump Trucks

Additional Equipment			Quantity






Can you meet the following requirments?
	1. General Liability Each Organization Occurrence $1,000,000 * Yes No
	2. General Liability Aggregate $2,000,000 * Yes No
	3. Auto Liability $1,000,000 * Yes No
	4. Workers Comp Statutory * Yes No

Additional Information and Comments? (Please tell us any additional information that you would like to be considered)

Please review and correct all information before submitting so that we can evalute your application properly.