Sub-Contractor Application

This field is for validation purposes and should be left unchanged.

Applicant Information

Name(Required)

First Last

Company Name(Required)

Phone: Home

Phone: Mobile(Required)

Address(Required)

Street Address City State ZIP Code

E-mail(Required)

Insurance

Current Liability Insurance(Required)

Yes

Liability Insurance Exp. Date

Liability Insurance Company Name

Current Workers’ Compensation(Required)

Yes

Workers’ Compensation Exp. Date

Workers’ Compensation Insurance Company Name

Copy of Certificate(s) of Insurance

Please upload a copy of your certificate(s) with Adam Vaillancourt Roofing LLC, 15 Stoneyard Drive Milford NH 03055 as a certificate holder. Accepted file types: PDF, JPG, PNG.

Drop files here or

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB, Max. files: 4.

Trucks & Equipment

# of Trucks

Truck Make & Year

List up to three trucks.

Make

Year

Condition of Truck(s)

Good

Fair

Poor

Is your truck lettered with your company name?

Yes

# of crew members (including yourself)

# of ladders

Enter how many of each ladder size you have.

24’

28’

32’

38’

40’

# picks

Sets of ladder jacks

Sets of roof jacks

Tarps

Walk Planks

Yard Magnet

Yes

Brakes

4’

10’

Experience

Do you hand nail, gun nail, or both?

Hand Nail

Gun Nail

Both

How many years in business?

How many years experience?

Number of years using the English language?

What kind of roofing?

Shingles

Rubber

Metal

Shakes

Slate

Gutters

Insulation

Commercial EPDM/TPO

Work History

Reasons you are currently looking for work?

Give the names of the last three contractors you have done work for:

Give the names of other companies you have owned or worked for:

Give the addresses of the last three jobs you have done:

EPDM / Rubber

Years of experience in EPDM residential installation

Years of experience in EPDM/TPO residential installation

Years of experience in EPDM/TPO Commercial

Companies worked for installing EPDM:

Names & Addresses of EPDM installation:

Metal

Years of experience in Metal Roof installation

Years of experience Metal “Shingles”

Years of experience Standing seam

Companies worked installing Metal Roofing

Names & Addresses of Metal Roof installation:

"*" indicates required fields

Step 1 of 5

Name

This field is for validation purposes and should be left unchanged.

What Type of Work Would You Like to Schedule?*

"*" indicates required fields

Step 1 of 5

This field is for validation purposes and should be left unchanged.

What Type of Work Would You Like to Schedule?*

Applicant Information

Insurance

Trucks & Equipment

Experience

Work History

EPDM / Rubber

Metal

Services

What Can We Do For You?