Contractor Company Information

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Name of Company:

Owner:

Registered Address:

Address Line 1

City

State / Province / Region

Postal Code

Country

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Tax ID #:

Phone:

Number of employees:

EMPLOYEES

emp1

Numbers

Name:

First

Last

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone:

ID Card given:

Yes
No

emp2

Numbers

Name:

First

Last

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone:

ID Card given:

Yes
No

emp3

Numbers:

Name:

First

Last

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone:

ID Card given:

Yes
No

emp4

Numbers:

Name:

First

Last

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone:

ID Card given:

Yes
No

emp5

Numbers:

Name:

First

Last

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone:

ID Card given:

Yes
No

For Elite Environmental Cleaning Services Only:

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Checkboxes

Copy of Company Registration received
Copy of Tax ID received

Contract client /Location:

Verified by

Start Date:

Contracted Service:

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+ 954-280-8402

4474 Weston rd #1151 ,USA

Monday / Sunday : 24/7