BrandPoint Services, Inc. (“BPS”) Subcontractor Application and Qualification Form

SECTION A – BUSINESS INFO


Business Name:Address:
City:State:
Zip:Contact Name:
Cell Number:Email:
Fax:Type of Business:
Federal ID or Tax Id:Corporation :
State License :  
SECTION B – CAPACITY
How many years have you been doing commercial work?Number of crews in peak season?
Number of crews in off season?How much ($) on average can you cash flow for the 60 day terms?
How far will you travel for BPS (in miles)?  
SECTION C – EXPERIENCE
Briefly describe your commercial experience, especially related to Retail, Hospitality, Healthcare and Banking  
SECTION D – SKILLS
Skills
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SECTION E – REFERENCES


LARGEST COMMERCIAL CLIENT

Company Name:Address:
City:State:
Zip:Contact Name:
Contact Phone:Email:


TRADE / SUPPLIER REFERENCE



Company Name:Address:
City:State:
Zip:Contact Name:
Contact Phone:Email:


BANK REFERENCE



Company Name:Address:
City:State:
Zip:Contact Name:
Contact Phone:Email:


SECTION F – BACKGROUND CHECKS


At a minimum, BPS requires SSN verification and criminal background searches for all workers.If you have already completed this process with your employee crews and/or subcontractor crews, please indicate below:
Employee Crews:Sub Crews:
Please initial here to acknowledge completion of this process:  
SECTION G – TERMS AND CONDITIONS
1. INSURANCE.

1.1. SUBCONTRACTOR'S INSURANCE.Before commencing the Subcontract Work, and as a condition precedent to payment, Subcontractor shall purchase and maintain insurance that will protect itself and BPS from any and all claims arising out of its operations under the Subcontract Documents, whether the operations are by Subcontractor, or any of its subcontractors, employees or agents, or anyone directly or indirectly employed by any of them, or for whose acts Subcontractor may be liable.
1.2. MINIMUM LIMITS OF LIABILITY.The insurance requirements of BPS include, but are not limited to, the following:
1.2.1.   Workers’ Compensation and Employers’ Liability Insurance covering all persons employed by subcontractor with the following limits: (i) Statutory Workers’ Compensation Limits as required by state law; and (ii) Employers’ Liability limits of not less than $500,000/$500,000/$500,000.
1.2.2.   Commercial General Liability Insurance covering Subcontractor’s ongoing Operations and Completed Operations as follows:
i   One million dollars ($1,000,000.00) per occurrence
ii  Two million dollars ($2,000,000.00) general aggregate
iii One million dollars ($1,000,000) personal and advertising injury
iv Two million dollars ($2,000,000) products and completed operations aggregate
v  Ten thousand dollars ($10,000) medical payments, per person
vi  Limits must apply on a “per project” basis
vii  Additional insured status must apply on a primary and non-contributory basis and apply to both ongoing Operations and Completed Operations
viii Must include Contractual Liability covering the duty to indemnify assumed by Subcontractor under this agreement or Subcontract Documents, independent contractors, waiver of subrogation, no cross suits or insured vs. insured exclusion if that exclusion applies to additional insureds, and separation of insureds clause.
1.2.3.   Commercial Automobile Liability Insurance covering all owned, non-owned and hired autos, including the loading and unloading thereof with a combined single limit of at least $1,000,000.
1.2.4.   Builder’s Risk Insurance or its equivalent, with per occurrence limits of coverage not less than one hundred percent (100%) of the full replacement cost of the Subcontractor’s Work done on the Project.
1.2.5.   Commercial Umbrella/Excess Liability Insurance with limits of no less than 1,000,000 and which must follow form.
1.2.6.   Subcontractor also agrees to satisfy any insurance requirements required by any governmental authority and those required by any agreement between BPS and Owner/Client.

2.   Neither the submission of this Application nor its approval constitute any grant of rights to perform any work, nor any warranty that Subcontractor will get any work now or in the future from BPS.

3.   In the event that Subcontractor is offered the right to perform any work for BPS, Subcontractor will need to comply with all requirements of BPS, including the execution of the then-current Work Order and Terms & Conditions.

4.   BPS has a VIP Membership Program for its vendors, which is detailed in the Work Order and Terms & Conditions. Ask for further details on this exciting Program.

Submissions required with this form:
1.   W9 (Business registration form/ID # if in Canada)



2.   Workers’ Compensation & Liability Insurance Certificates, with BrandPoint Services, Inc., 150 Green Tree Road, Suite 1003, PO Box 115, Oaks, PA 19456 listed as Certificate Holder and as additional insured



3.   Copy of state license (as required).



4.   References (see Section F)




Agreement:

I    attest that the information provided herein is accurate and complete, fully understand the conditions and requirements as described herein, and agree to be governed by said conditions and requirements. The undersigned acknowledges that he/she has the authority to submit this Application on behalf of the individual or business entity identified in Section A above.