Fields marked with an asterisk (*) must be filled out before submitting.

Personal Details

First Name: *
Last Name: *
Company Name: *
Email Address: *

Contact Details

Address: *
City: *
State: *
Cell phone: *

Services Provided

Services Provided: * Plumbing
Kitchens Remodels
bathroom remodels
Coverage Areas Please Provide Counties or Zipcodes: *
Contractor License Numbers *
Trade References (Contact Name, Phone, Address) *
List Four of your Most Significant Projects Currently Under Construction: Name & Location Contact Name/Phone Contract Amount Completion
Years in Business? *
Total Number of Permanent Staff Employed by Company? *
Do you Carry General Liability Insurance? * Yes
Do you Carry Workers Compensation Insurance? * Yes
Have you ever been convicted of a felony?: * Yes
Have you or any owner/officer/director of your company ever been convicted of any crime or offense involving fraud, theft, property destruction, larceny or burglary?If so please explain
Do you authorize American Field Services inc to conduct a criminal background check on you and your company? Yes
How did you hear about American Field Services Inc?

Please Provide Photos of Previous Work

Job (1)
Job (2)
Job (3)
Job (4)
Job (5)
Job (6)
* Do you acknowledge and understand that if American Field Services Inc. retain you, you will be working as an independent contractor/vendor. The completion of this application does not create an employee/employer relationship between American Field Services Inc and its affiliate clients; and you, your company or your employees. It is the intent of all the parties that every vendor/contractor performing work for American Field Services Inc is and remains an independent vendor/contractor and not employees of American Field Services Inc or any of its affiliate clients; No vendor/ has the right to receive work from American Field Services Inc.
* I affirm that the information provided on this vendor application is true and complete. I understand that any false information, misrepresentations or omissions, oral or written, may disqualify me from further consideration and may result in disolving my independent contractor relationship with American Field Services inc. I authorize American Field Services inc to investigate all statements contained in this vendor application, including references, police departments, and any other background check or sources concerning me. I authorize all such references and sources (and the company) to release this information without liability for damage resulting from such releases. I waive any written notice of the release of such records that may be required by state or federal law.