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This applicaton is for independent contracters intrested in recieving cleaning job opportunities with Palmer Cleaning Service. This is a 1099 contracter positon. There are no guaranteed hours. Contracters may accept or decline jobs as offered.

First name

Last name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Business name if applicable

Are you a Sole Proprietor or LLC?

EIN or Social for W-9 purposes

INSURANCE AND BONDING REQUIREMENTS

-General Liability Coverage Minimum $1,000,000

-Aggregate Coverage: Minimum $2,000,000

-Commercial Bond (Janitorial Bond) Minimum $10,000 Required

-Palmer Service must be listed as certificate holder

Insurance Provider

Policy Number

Bond Provider

Bond Number

Do you have your own cleaning equipment?

Years of cleaning experience?

Are you willing to do a background check?

Yes

iI certifty that the information provided is accurate and complete. I understand this is a contracter opportunity and not empoyment. Submiss of this form doesn't guarantee job assignments. I acknowledge that the proof of insurance and bonding meets the standard minium coverage is required prior to recieving work.

Signature

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