Service Provider

Are you capable of performing trash removal, landscaping, and yard maintenance efficiently, cost-effectively, and at the highest quality?  Do you believe that a premium workforce is every company’s greatest asset?

If so, Regis Development would like you to consider working with us.  We often have overflow work in property preservation, and because our orders fluctuate weekly, we need to expand our network of service providers.  If you can provide consistent, reliable performance and can benefit from additional work, please complete the form below.  A member of the Regis Development Human Resource team will contact you.

To find out if you need a contactors licence visit www.contractors-license.org

Online Form

Name:
Company Name:	DBA:
Company Address:	Federal Tax ID#
Telephone:	Email:
Company Zip Code:
Emergency Contact / After Hours:	Emergency / After Hours Telephone:
Billing Contact Name:	Billing Contact Telephone:
Current Active License(s):	How long have you been licensed?
Do you currently have an active business license?	Type of License:
Yes No Please make a selection.	LLC "S" Corporation "C" Corporation PLC
Do you posses a bond?	Has it ever been attached?
Yes No Please make a selection.	Yes No Please make a selection.
Liability Insurance Carrier:
Agents Name:	Telephone:
Workers Compensation Carrier:
Agent Name:	Telephone:
Covereage Amounts
Liability:	Workers Compensation:
How many Years Experience:
Framing None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs HVAC None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs Plumbing None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs Electrical None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs Cabinets None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs Countertops None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs Roofing None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs Painting None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs Carpet None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs Tile None 0-1 yr 1-3 yrs 3-5 yrs 5+ yrs
Equipment
Digital Camera	Generator
Compressor	Laptop Computer
Scanner	Mobile Phone
Tell us about your company
Southern California Areas:
Orange County	Riverside County
Ventura County	San Bernardino County
Los Angeles County	San Diego County
Santa Barbara	Palm Springs / Indio
Northern California Areas:
San Francisco	Alameda County
Alpine County	Amador County
Butte County	Calaveras County
Colusa County	Contra Costa County
Del Norte County	El Dorado County
Fresno County	Glenn County
Humboldt County	Inyo
Kings County	Lake County
Lassen County	Sacramento
Chico	Yuba City
Central California Areas:
Fresno	Merced
Bakersfield	Monterey
Hollister	Salinas
Madera	Sonora
Mariposa	Turlock
Modesto	Visalia

• 24 hour Rekey
• Trash Outs
• Landscape
• Interior Clean
• Carpet Clean
• Spruce Ups
• Board up
• Securing
• Pool Clean
• Repairs
• Paint
• Emergencies