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SERVICE PROVIDER REGISTRATION
Thanks for your interest in becoming a service provider with Glab Maintenance Services. We are a facility management company, specializing in servicing all our clients’ needs around the entire nation. It is our goal to work with qualified vendors to meet these needs. We want the very best providers and appreciate you taking time to answer the following questions.



YOUR INFORMATION
*Company:
*Address:
*City:
*State:
*Zip:
*Phone:
*Email:
Other Phone:
Website:
Geographical Area Serviced:
*Services Offered:
(list as many as you offer)
*Do you offer 24 hour emergency service?

Response time to be on site for emergencies:


Contact number for emergencies:
*Do you carry liability insurance of at least $1,000,000?
*Do you carry the needed amount of workman’s compensation insurance based on your local requirements?


CURRENT RATE INFORMATION
*Regular Hourly Rate:
Hours Applicable:
Overtime Rate (1):
Hours Applicable:
Overtime Rate (2):
Hours Applicable:
Holiday Rate:
Hours Applicable:
Other:
Hours Applicable:
Emergency Charges (describe):
Hours Applicable:
Emergency Charges (describe):
Hours Applicable:
Trip Charge:
Hours Applicable:
Mileage Rate:
Hours Applicable:
Other Rate Notes:
*Other Information You Would Like to Provide :
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