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Preferred Vendor Application

Step 1 of 6 - Company Information

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Company Name*
Address*
Street Address Address Line 2 City State ZIP Code
Company Website
Company Type
- Corporation
- Partnership
- Proprietorship
- LLC
Years in Business*
Regions/Sub-Markets Covered
Union
- Union
- Non-Union
COI or EOI upon request
FEIN*
W-9 Form*
Builder's License Number*
Primary Contact*
Direct Line
Cell
Primary Contact Email*
Please provide a description of your service line*
(Also attach a list of commercial grade equipment used)
Does your company perform background checks?*
- Yes
- No
Have you provided services to Kirco?*
- Yes
- No
When did you provide services to Kirco?*
Does your company have a published Safety Manual?*
- Yes
- No
Does your company have a COVID-19 Preparedness and Response Plan?*
- Yes
- No
Please note that in the event that your company does not have the above Safety and COVID-19 documents in place, they will be required prior to performing any services on behalf of KIRCO, as Agent for Owner. Upon request, KIRCO will provide examples of this required documentation for your reference.

Principal/Owner*
Title*
Work Phone*
Cell Phone*
Email*
Principal/Owner
Title
Work Phone
Cell Phone
Email

Accounts Payable Contact*
Work Phone*
Email
Bidding Contact Person*
Work Phone*
Email*

Reference #1 Name/Title*
Company*
Address*
Street Address Address Line 2 City State ZIP Code
Work Phone*
Cell Phone
Email*
Reference #2 Name/Title*
Company*
Address*
Street Address Address Line 2 City State ZIP Code
Work Phone*
Cell Phone
Email*
Reference #3 Name/Title*
Company*
Address
Street Address Address Line 2 City State ZIP Code
Work Phone*
Cell Phone
Email*

Bank Name*
Contact*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Account Number*

Do you provide 24 hour response?*
- Yes
- No
Do you ever sub-contract your work?*
- Yes
- No
Do you offer any type of payment discounts?*
- Yes
- No
Please specify*
Does your company have any Property Management or Construction needs KIRCO can assist you with?*
- Yes
- No
Additional Notes
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Development
▼
- Services
- KIRCO Senior Living
Construction
▼
Property Management
▼
Our Work
▼
- Our Work
- Video Library
About
▼