Durham Region Roofing Ltd. (905) 999-9069
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Subcontractor Form
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Applicant Name
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First
Last
Policy Number
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Name of Business
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Number of Years in Business Under this Name
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1-2 yrs
2-5 yrs
5+ yrs
Is Your Business Currently Registered in Ontario?
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Yes
No
Do you currently have both WSIB Clearance and Liability Insurance?
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Yes
No
WSIB Registration Number
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Liability Insurance Company
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Do you own/lease your own vehicles, and have all required tools and equipment?
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Yes
No
Do Your Employees Have Fall Safety Training and Equipment?
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Yes
No
On Average, How Many Crew Members are Present on Site?
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Other Companies You've Subbed Off Of
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Any Jobs (Addresses) You Would like to Show Us You've Completed As a Reference (Homeowners will not be contacted)?
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