BelVan Preferred Vendor/Sub Trade Application Form
Company
*Company Name:		*Phone:
*Address:		Fax no.:
*City, Province:		Postal Code:
*Contact Name:		Phone:
Owner (if different from above):
Organization
*Sole Owner:	Partnership:	Corporation:
Partner's Name (if applicable):		*Started in (mm/yyyy):
Company's Previous Name (if applicable):
Insurance
*WCB Registration No.:		*Are you current? (Y/N):
*Liability Insurance Provider:
*Policy No.:	*Coverage Amount $:	*Expiry Date (mm/yyyy):
*Information
Services	Products	Special Equipment
1.	1.	1.
2.	2.	2.
3.	3.	3.
4.	4.	4.
5.	5.	5.
General Contractor References
Company Name	Contact Name	Phone
*1.
*2.
*3.
Supplier References
Company Name	Contact Name	Phone
*1.
*2.
*3.