Contact Details 818.556.6401 firstname.lastname@example.org
Attach Certificate of Insurance, General Liability Insurance, and Workers Compensation Insurance
Insurance and Worker's Compensation Requirements
Service provider agrees to defend and indemnify Maintco Corp. from liability associated with work performed as follows:
Service Providers shall comply with all federal, state and locallaws relating to Worker's Compensation, Unemployment Compensation and Social Security withholding.
Please submit a copy of your Certificate of Insurance, which clearly identifies the following:
Please Complete this section if Worker's Compensation is NOT applicable to your company.
I certify that Iam the sole owner/operator of the company listed above and I do not have any employees. I will provide a certificate of Worker's Compensation Insurance to Maintco Corp. within 10 days of hiring any employees. Workers Compensation including employers' liability with minimum limits of $1,000,000 and include a waiver of subrogation in favor or Maintco Corporation.
Please fill out Facilities, Construction, or both
Please download and complete this Facility Service Contract. Then upload for submission
Please download and complete this Construction Contract. Then upload for submission