Subcontractors Interested in providing services to the Kevin Miller Group — Kevin Miller Group LLC

Subcontractor Questionnaire

Before we can partner with you as a subcontractor, we need to gather some information to keep on file. Please note: this is not a legally binding agreement or contract guaranteeing work. A formal contract will be signed by both parties after this information has been collected.

Name

First Name

Last Name

Phone

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Website (optional)

http://

Contractor License Number

You must have a valid contractor’s license in the state of Washington.

Broker's Name

You must provide written proof of sufficient insurance coverage as agreed on by both parties. We require that we keep your insurance broker’s information on file.

Broker's Phone Number

(###)

###

####

Moving Forward with Kevin Miller Group LLC

I understand that the completion of this form does not constitute a work order or a notice to proceed.

I Agree that this is not a work order or a notice to proceed.