Contractor Intake Form

BRC Contractor Intake Form

Name(Required)

First Last

Company Name(Required)

Business Address(Required)

Street Address Address Line 2 City State ZIP / Postal Code

Email(Required)

Phone(Required)

Select the States You Can Provide Services(Required)

Contractor Services(Required)

Unit Turns

Roofing

HVAC*

Plumbing*

Electrical*

Countertops / Granite Fabrication/Installation*

Countertops / Laminate Fabrication/Installation*

Cleaning Services

Select the services you are interested in providing.

* Please include Licenses for states you are requesting to work.

Please upload form W9

Drop files here or

Max. file size: 100 MB.

*Please upload BWC for States you are requesting to do service

Drop files here or

Max. file size: 100 MB.

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