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Provider Network Application

First Name *

Last Name *

Mobile Phone *

Office Phone

Email *

Title / Position with Company *

Enter your position within the company (e.g., Owner, President, Managing Member, Operations Manager, Authorized Representative).

🏢 Company Information

Organization *

Website

Address

Business Address

City

State

Country

Postal Code

Years in Business *

Trade Specification *

Briefly describe your company, services offered, experience, and areas of specialization. *

🌐 Online Presence

LinkedIn Page

Facebook Business Page

Instagram Business Page

Google Business Profile URL

📍 Service Areas & Licensing

Areas Licensed *

Business License(s) *

PDF, PNG, JPEG, JPG, DOCX or DOC ( max 9 Files )Upload any business license(s) required for the service areas listed above.

Business License Expiration Date *

Certificate of Insurance *

PDF, PNG, JPEG, JPG, DOCX or DOC ( max 3 Files )

Insurance Expiration Date *

🗂️ Supporting Documents

W9 *

PDF, PNG, JPEG, JPG, DOCX or DOC ( max 2 Files )

Government-Issued Photo ID *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 3 Files )

💰 Pricing Schedule

Do you provide unit turnover services? *

The pricing provided below are intended as a general pricing framework only and does not constitute a guaranteed price. Actual pricing may vary based on ceiling height, wall and trim colors, accent walls, and other property-specific factors.

Unit Turnover Pricing Acknowledgment *

I understand that the turnover pricing provided below is based on a vacant unit in average condition with standard painting, up to 2 hours of minor wall preparation, and up to 4 hours of handyman labor. Conditions outside this scope may result in additional charges.

What is your typical labor-only price for a 1-bedroom apartment unit turnover? *

$

Price includes minor skim work, painting and up to four (4) hours of handyman labor.

What about a 2-bedroom apartment? *

$

A 3-bedroom apartment? *

$

4-bedroom apartment? *

$

How are routine service calls or work order requests typically billed? Check more than one if applicable.

Flat-Rate

Hourly Pricing

Project-Based Estimates

Other

🔎 A routine service call or work order request refers to a specific repair or maintenance task that does not require milestone payments, extensive coordination, or ongoing project management.

Other Pricing Method *

How would you like to provide your flat-rate pricing information? *

Upload price-list *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 5 Files )

Provide link to price list *

What is your standard charge for a routine work order service call, including travel, diagnosis, and up to the first hour of labor? *

$

What is your standard charge for a routine work order service call, including travel, diagnosis, and up to the first hour of labor?

What is your hourly labor rate after the first included hour? *

$

Additional labor should be calculated and billed in 30-minute increments.

Do you accept emergency requests? *

When is your company available for emergency service? Check more than one if applicable.

Business Hours Only

Evenings & Weekends

24 Hours / 7 Days Per Week

Case-by-Case

🤝 Professional Reference #1

Please provide a professional reference familiar with your company's work.

Company Name *

Full Name *

Phone *

Email *

Describe Relationship *

Professional Reference #2

Please provide a second professional reference.

Company name *

Full Name *

Phone *

Email *

Describe Relationship *

Professional Reference #3

Optional additional professional reference.

Company Name *

Full Name *

Phone *

Email *

Describe Relationship *

Additional Qualifications (Optional)

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 5 Files )Upload a resume, capability statement, company profile, project list, brochure, service menu, or other document that helps us better understand your company's experience and capabilities.

📄 Review Agreement

✅ Certifications & Acknowledgements

Please review and acknowledge the statements below.

I understand that applications are reviewed prior to approval and that the Company may verify licenses, insurance, references, online presence, business registrations, public records, and other relevant information before approving participation in the network.

Provider Network Application

🏢 Company Information

🌐 Online Presence

📍 Service Areas & Licensing

🗂️ Supporting Documents

💰 Pricing Schedule

🤝 Professional Reference #1

Professional Reference #2

Professional Reference #3

📄 Review Agreement

✅ Certifications & Acknowledgements

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