ZVN | Vendor App

General Information

Company Name:

Federal Tax ID:

Street Address:

Business Type:

Sole Proprietor Partnership LLC Corporation

City:

State:

Zip:

Contact Information

Primary Contact:

Business Phone:

Cell Phone:

Email Address:

Alternate Contact:

Business Phone:

Cell Phone:

Email Address:

Background Information

Have you ever been convicted of a Misdemeanor?
(Please Include any Drunk Driving-related charges)

Yes No

If yes, please detail the circumstance(s) below:

Have you ever been convicted of a Felony?
(Please Include any Drunk Driving-related charges)

Yes No

If yes, please detail the circumstance(s) below:

Company Information

Years in business:

Full-Time office staff?

Yes No

Office hours:

Which of the following services does your company currently provide?

Inspections

Prop Pres

REO Services

Repairs

How many inspectors do you utilize in your service area?

How many work crews do you utilize in your service area?

Are you willing and able to work nights/weekends to meet deadlines?

Yes No

What state(s) is your company applying to service?

State 1:

State 2:

State 3:

State 4:

State 5:

Does your company use a work order management system?

Yes No

If so, what system is used?

What operating system does your company use?

Explain the general coverage area your company will service (counties, zip codes, radius, etc.):

*A more detailed explanation will be required if the application process continues.

Please provide three business references:

Business Name:

Contact Name:

Phone:

Comments:

Business Name:

Contact Name:

Phone:

Comments:

Business Name:

Contact Name:

Phone:

Comments:

Please provide a list of clients your company has worked for:

Client Name:

Still Provide Services?

Yes No

Client Name:

Still Provide Services?

Yes No

Client Name:

Still Provide Services?

Yes No

Client Name:

Still Provide Services?

Yes No

Client Name:

Still Provide Services?

Yes No