Vendor Application - Midwest Property Logistics

Vendor Requirements

W-9

Contractor shall provide a signed W-9 document.

General Liability

General Liability insurance in an amount not less than $1,000,000 for any occurrence, $2,000,000 general aggregate $2,000,000 Products/Completed Operations aggregate limit. Insurance shall list Midwest Property Logistics as the Certificate Holder.

Worker’s Compensation Insurance

Workers’ Compensation insurance covering the legal liability of the Contractor and its Subcontractors under applicable workers’ compensation or occupational disease laws. The Subcontractor shall provide to Contractor a Workers Compensation Policy or a Workers Compensation Exemption Certificate.

Name *

First

Last

Company Name

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you willing to allow us to process a background check & drug test? *

Please list your skills and construction abilities

Do you currently meet the insurance requirements listed? *

If not are you willing to obtain the insurance listed? *

Please list 3 business references & contact info *