Vendor / Subcontractor Application

Primary Point of Contact

Name

Title

Phone

Email

Website & Social Presence

Optional. Include links so we can learn more about your business.

Website

Facebook

Instagram

Business Size & Revenue

Number of Employees

Work Comp EMR

Safety & Compliance

Written safety program?

Yes

No

Files OSHA reports?

Yes

No

Employee training program?

Yes

No

Alcohol / drug prevention program?

Yes

No

Uses SCR for preliminary lien notices?

Yes

No

Uses purchase order systems?

Yes

No

Legal History

Bankruptcy / receivership / reorganization?

Yes

No

Ever failed to complete a contract?

Yes

No

Any liens or claims pending?

Yes

No

Currently in litigation or arbitration?

Yes

No

OSHA violations in past 3 years?

Yes

No

If you answered Yes to any question above, please explain

Project References (Last 3 Years)

Please provide past or current projects completed within the last three years.

Business Experience & Qualifications

Describe your business experience and qualifications

Required Documents

Please upload the following documents. Accepted formats: PDF, JPG, PNG. Max size: 15MB per file.

General Liability Insurance Certificate

Patterson Homes must be listed as the Certificate Holder

Work Comp Insurance OR Work Comp Waiver

Copy of Current Contractor License (if applicable)

Current W9 Form