Independent Contractor Application | Sentinel Property Services

User Account Information

Name

Email Address

Confirm Email Address

Password

Confirm Password

General Information

Company Name:

Description of Primary Business:

Type of Entity:

Federal Tax ID or SSN:

Address 1:

Address 2:

City:

State:

Zip Code:

Office Phone:

Office Fax:

Contact Person:

Mobile Phone:

Primary Email:

Alternate Contact:

Mobile Phone:

Secondary Email:

Company Website:

Have you ever been contracted with Sentinel Property Services LLC before?

If yes please provide Vendor ID with contract dates.

Licensing Information

Type of License:

License Number:

Issuing State:

Expiration Date:

Insurance Information

Do you have liability insurance?

Name of Insurance Company (minimum $1,000,000 required):

Agent Name:

Agent Phone:

Do you have Worker's Compensation Insurance?

Name of Insurance Company:

Agent Name:

Agent Phone:

Additional Information

Are you legally eligible to work in the United States (verification required)?

Do you agree to obtain any and all licenses that may be required to do business as an independent contractor or self-employed person?

Do you agree to obtain any and all insurances that may be required to do business as an independent contractor or self-employed person?

Do you understand that as an independent contractor, you would not be eligible for unemployment benefits at the end of any contract?

Do you understand that as an independent contractor, you would be responsible for payment of any and all state and/or federal income, Social Security, self-employment taxes, unemployment taxes and payroll taxes and that you will receive a 1099 for services provided to Sentinel Property Services by you?

Are you or your company involved in any litigation related to the performance of property preservation and or protection services?

If yes, provide details:

Do you work directly for the mortgage servicing industry or our competitors?

If yes, who?

Have you ever been convicted of a crime?

If yes, please explain:

Does Sentinel Property Services LLC have your permission to cause a background check to be performed?

If no, please explain:

Were you referred to Sentinel Property Services LLC?

If yes, by whom?

Experience

List type of work experience (ie. carpentry, lock change, landscaping, janitorial, etc.):

Check types of contracting experience. Please check all that apply.

Professional References

Please provide the names of 3 professional references that we may contact.

Reference 1

Name:

Title:

Office Phone:

Mobile Phone:

Reference 2

Name:

Title:

Office Phone:

Mobile Phone:

Reference 3

Name:

Title:

Office Phone:

Mobile Phone:

Existing Contractual Relationships

Please list all current independent contractor relationships.

Relationship 1

Company:

Contact

Address:

City:

State:

Office Phone:

Industry Type:

Obligations:

Start Date:

End Date:

Monthly Hours Worked

Relationship 2

Company:

Contact:

Address:

City:

State:

Office Phone:

Industry Type:

Obligations:

Start Date:

End Date:

Monthly Hours Worked

Relationship 3

Company:

Contact:

Address:

City:

State:

Office Phone:

Industry Type:

Obligations:

Start Date:

End Date:

Monthly Hours Worked

Preferences

In which areas do you prefer to work? (Please list by State and City or zip code.)

Are you willing to work outside of these areas?

If yes, list areas:

Check all types of work you are able to perform:

How many hours are you able to work?

How many days of the week are you able to work?

What is the earliest date you can begin work?

Technology Information

Do you own a computer?

Do you have access to high speed internet?

Do you own a digital camera?

Do you own a flatbed scanner?

Do you own a mobile PC device? (ie. PDA, laptop computer, Smart Phone)