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LuxLand Maintenance
15455 Conway Rd | St. Louis MO 63017
Preferred Vendor Sign Up
We are looking for qualified service providers to work with in markets throughout the US.
Please fill out this form to be considered for opportunities in your area.
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Business Name*
Title
First Name*
Last Name*
Address*
City*
State*
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Zip Code*
Email*
Business Phone Number*
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Cell Phone Number
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Fax Number
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Services that you/your company provide*:
Areas service*:
List of equipment*:
References*: (at least one)
Do you/your company have Comprehensive Liability Insurance coverage*?
Yes
No
Can you/your company provide a Certificate of Insurance*?
Yes
No
Do you/your company have Workers Compensation Insurance*?
Yes
No
Is it your/your company's equipment*?
Yes
No
Would you/your company have to rely on subcontracting someone else and their equipment*?
Yes
No
Will the laborers be your/your company's own full-time employees*?
Yes
No
Will you/your company have to secure laborers from an outside source*?
Yes
No
Do you/your company have a back-up in the event of an equipment failure*?
Yes
No
What would be the response time for the back-up equipment*?
How many years of experience in this service do you/your company have*?
