Snow Removal Subcontractor Application

Complete the information below:

Equipment List

Equipment 1 (Make, Model, Year, Attachment, Desired Rate)

Equipment 2 (Make, Model, Year, Attachment, Desired Rate)

Equipment 3 (Make, Model, Year, Attachment, Desired Rate)

Equipment 4 (Make, Model, Year, Attachment, Desired Rate)

Snow Removal Experience

Experience 1 (Year, Company, Equipment, Responsibilities)

Experience 2 (Year, Company, Equipment, Responsibilities)

Experience 3 (Year, Company, Equipment, Responsibilities)

Please Also Provide the following Information:

Workers Compensation-Statutory

Employers Liability - $1,000,000

Automobile Liability

Bodily Injury - $250,000/person

$500,000/occurence

Property Damage - $100,000 occurence

Comprehensive General Liability - $1,000,000

For all Vehicles (Insurance Cab Card, Drivers License of Operator)

W-9 Form

Company Information

Equipment List

Snow Removal Experience

Please Also Provide the following Information: