Contact Us

Reason for Contacting Us

J.C. Restoration welcomes the opportunity to have your company become a trusted trade partner. To properly vet your company, we will require you to complete the information requested below. Once this information is submitted to JCR, you will be contacted for an interview and if approved, a subcontractor packet will be sent to you which will include the following documents: Master Sub Contract; Certificate of Insurance including general liability and workers compensation insurance; and Form W-9.

ARE YOU A CONTRACTOR?

COMPANY NAME*

POINT OF CONTACT

* ARE REQUIRED FIELDS
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
PHONE*
CELL PHONE*
Hidden
FAX*
Email*
WEBSITE ADDRESS IF APPLICABLE*
Hidden
YEARS IN BUSINESS*
Hidden
NUMBER OF OFFICE EMPLOYEES*
Hidden
NUMBER OF TRADESPERSONS*
HOW DID YOU HEAR OF JCR?*
INTERESTED IN THE FOLLOWING*
HAVE YOU EVER WORKED FOR ANY OTHER RESTORATION COMPANIES?*
- Yes
- No
WHAT TYPE OF PRODUCTS DO YOU PROVIDE?*
MESSAGE*

ORGANIZATIONAL INFORMATION

PRODUCT RELATED INFORMATION

FINANCIAL INFORMATION

* ARE REQUIRED FIELDS
Hidden
ANNUAL REVENUE*
Hidden
FORMS OF PAYMENT*
- AMEX
- VISA/MC
- CHECKS

LICENSE, INSURANCE & BONDING RELATED INFORMATION

Hidden
LICENSE, BONDED, INSURED?*
- LICENSED
- BONDED
- INSURED

JC Restoration Insurance requirements below:

The below must be listed under Description of operations:

“It is agreed the following are added as additional insured on the general liability on primary and non-contributory basis with respect to the operation performed by the Name Insured. A waiver of subrogation applies to the general liability and workman’s compensation policy in favor of the following when required by written contract”. 

Coverages

The liability policy must include JC Restoration, Inc. as the additional insured by endorsement on a primary non-contributory basis with limits of 1 MIL/2 MIL. The workman’s compensation policy must include statutory limits of 500K.
Sub-contractor will maintain an umbrella liability policy with the same additional insured as the basic policy in the amount of 1 MIL.
Sub-contractor is required to waive any rights of subrogation with respect to JC Restoration, Inc.
The certificate of insurance must list all of the requirements above and provide a mn. of 10-day notice of cancellation to JC Restoration, Inc. as the certificate holder.
If you are a sole employee, a notarized letter stating such will be required in lieu of a workman’s compensation policy.

PERFORMANCE/HISTORY INFORMATION

ANNUAL REVENUE *
PROVIDE REFERENCES INFORMATION FROM LAST FOUR PROJECTS COMPLETED.
CLIENT #1
Hidden
ANNUAL REVENUE*
Hidden
ADDRESS*
Hidden
PHONE*
Hidden
EMAIL*
CLIENT #2
Hidden
ANNUAL REVENUE*
Hidden
ADDRESS*
Hidden
PHONE*
Hidden
EMAIL*
CLIENT #3
Hidden
ANNUAL REVENUE*
Hidden
ADDRESS*
Hidden
PHONE*
Hidden
EMAIL*
CLIENT #4
Hidden
ANNUAL REVENUE*
Hidden
ADDRESS*
Hidden
PHONE*
Hidden
EMAIL*

CAPTCHA

RECEIVE OUR NEWSLETTER

Yes, sign me up!

Phone

This field is for validation purposes and should be left unchanged.

* ARE REQUIRED FIELDS

ARE YOU A CONTRACTOR?

POINT OF CONTACT

* ARE REQUIRED FIELDS

ORGANIZATIONAL INFORMATION

* ARE REQUIRED FIELDS

PRODUCT RELATED INFORMATION

* ARE REQUIRED FIELDS

FINANCIAL INFORMATION

* ARE REQUIRED FIELDS

LICENSE, INSURANCE & BONDING RELATED INFORMATION

JC Restoration Insurance requirements below:

The below must be listed under Description of operations:

Coverages

PERFORMANCE/HISTORY INFORMATION

ANNUAL REVENUE *

PROVIDE REFERENCES INFORMATION FROM LAST FOUR PROJECTS COMPLETED.

CLIENT #1

CLIENT #2

CLIENT #3

CLIENT #4

Need Help Now?

Get Help

800-956-8844

Request Help

We Work With Your Insurance