If you're an officially licensed and insured contractor and would like to work in the park, please complete our contractor application.
Business name: _____________
Applicant’s name: _________________
City, State, Zip: ________________________
Business Phone: _______________________
Cell Phone: ___________________________
Contractor’s License #:___________________
Brief description of Services offered: _________________
I certify that the aforementioned business, and/or its subcontractors, have liability insurance coverage for the type of work or service provided or performed within the property of RBMC. I also certify that the aforementioned business, and/or its subcontractors, have the required workers’ compensation insurance as required by law. I understand that liability insurance and workers’ compensation insurance must be maintained as applicable and current coverage present to perform work or provide services within the property of RBMC (copies provided). I agree to and understand that the aforementioned business, and/or its subcontractors, will comply with OSHA regulations while performing work or providing services within RBMC. I represent and warrant that neither I nor any employees, and/or those of our subcontractors who will perform work within RBMC have ever been convicted of a felony, including a felony that requires registration under Sex Offender Registration Act. I also understand that I must comply with permit requirements and rules of RBMC, State and local building code requirements and be responsible for all required permits. I agree to defend, hold harmless and indemnify RBMC for any injuries, accidents or any other issues regarding delivery or completion of services to members within RBMC. Please ask your insurance carrier to list RBMC as a certificate holder and attach a copy of your workman’s Compensation and Liability Insurance to this form. We also require copies of your current Building, Mechanical and/or Electrical Licenses.
Printed Name ___