Crowder Disaster Recovery
901 Geddie Rd
Tallahassee, FL 32304
Office: 850-576-7176
Fax: 850-576-1542
terry@jimmiecrowder.com
Sub-Contractor Application (1 of 3)
Crowder has an extensive database of highly qualified subcontractors that help augment our available services, supplies, and equipment in the event of a disaster occurrence. We strive to hire local contractors and always patronize the local businesses. To join the Crowders association of team members and participate in disaster operations please fill out the forms on the following page.
GETTING STARTED
Welcome to the Crowder subcontractor application form. Before proceeding with the next steps, please be sure to have the following information:
• Legal Company Name
• Federal Employer Identification Number
• Social Security Number
• Copy of Completed W-9 Form
• Copy of Insurance Certificate
TERMS AND CONDITIONS
By providing the information requested to Crowder, you promise that all information you provide will be accurate, current and truthful to the best of your knowledge. You further agree and acknowledge that Crowder will be relying on the information, that Crowder has no obligation to retain you as a subcontractor and that Crowder reserves the sole and exclusive right to retain any subcontractor or no subcontractors at all for a particular project.
TO KNOWINGLY INPUT FALSE INFORMATION, INCLUDING, BUT NOT LIMITED TO NAME, PHONE NUMBER, ADDRESS AND COMPANY DATA IS A VERY SERIOUS AND FRAUDULENT MATTER THAT COULD RESULT IN SIGNIFICANT COSTS AND DAMAGES, AS WELL AS LOSS OF TIME, EFFORT AND EXPENSE, AND ACCORDINGLY, IF YOU PROVIDE FALSE INFORMATION YOU WILL FULLY INDEMNIFY CROWDER AND BE LIABLE FOR ACTUAL DAMAGES, DIRECT, PUNITIVE AND CONSEQUENTIAL, AND ANY REGULATORY OR JUDICIAL FINES OR PENALTIES THAT MAY ARISE FROM SUCH MISLEADING, HARMFUL AND FRAUDULENT INFORMATION, PLUS REASONABLE LEGAL FEES, COST AND EXPENSES RELATING THERETO.