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Subcontractor Registration Form
Company/Person Name:
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Contact Name:
*
Address:
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City
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State
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Zip Code
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Phone:
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Email Address:
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Licence Number (If applicable):
EXPIRATION DATE:
Category
Electrical
Utility
Low Voltage
Communications
Voice/Data
Security
Alarm Systems
Access Control
CCTV Surveillance
General Contractor
Plumber
Other
Certification Acknowledgment
(Check box to indicate acceptance.)
I certify that the information provided on this form is accurate to the best of my knowledge and that it is my responsibility to submit an updated form with current information should any of it change. I understand that will be contacted to provide additional information including but not limited to Contractor's License, Individual Driver's License, EIN and/or SSN, Certificate of Insurance and/or Trade Certifications.
By submitting this form, I agree that I am freely and voluntarily registering as a Subcontractor of WISE Building Technologies and requesting to be contacted to perform work for WISE Building Technologies as an independent contractor. I certify that I have reviewed and agree with the Subcontractor Agreement terms and conditions provided at
Subcontractors Agreement.
Any communication and/or information sent by WISE Building Technologies is for information purposes only and do not create a business relationship or contract. No such relationship is created or deemed to be created by visiting this website or by contacting us.
SIGNATURE (Enter full name):
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