Extended Family WANT TO WORK WITH US? EXTENDED FAMILY Affiliate Partner Application Form Step 1 of 2 - Sub-contractor Information: 50% Sub-contractor Information:Legal Business Name* First Point of Contact Full Name* First Point of Contact Position* Email Address* Phone No.*Cell Phone NumberAddress (Physical Address)* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Company Website Federal Tax ID Number or Social Security Number:* Do you have General Liability Policy:* Yes No Do you have an Auto Insurance Policy on company vehicles? (personal if using personal car)* Yes No Do you have Workers Compensation Policy?* Yes No Do you have any certifications? OSHA, ISSA, etc):* Yes No What size is your company?* Small Medium Large Tell Us About Your Business:What services does your company specialize in? Click all that applies:* Flooring (Strip and Wax, Wood, Carpet, Marble) Post-construction General Commercial Cleaning Residential Cleaning Trash Removal Parking Lots Other? Untitled What is your ideal contract? (This is used for job pairings) Which industry are you currently serving? Click all that applies:* Restaurant Retail Government Medical Other: Untitled What is your current number of employees? (if you do not have any, skip to the next question). What is your current number of contractors? What is your largest square footage building currently being serviced by your Company How did you hear about us?* Google One of our Employees One of our Clients Facebook Others How did you hear about us?* Google One of our Employees One of our Clients Facebook Other: Untitled Are you currently using a distributor? If so who? Briefly describe your professional cleaning experience* List of equipment that you are currently using.*Days Available* Monday Tuesday Wednesday Thursday Friday Saturday Sunday (check all the days you can work)✔ I hereby declare that all statements contained in this application are true and correct and understand that false or inaccurate information in the application will be the basis for termination. I hereby authorize TOH Cleaning to investigate my background inclusive of criminal and verify this information. I understand that if selected, my relationship will be for a fixed period and may be terminated at any time by either party given proper notice.
