Real Estate Vendor Questionnaire

REAL ESTATE VENDOR QUESTIONNAIRE

This Real Estate Vendor Questionnaire is intended to collect factual, licensure, insurance and compliance information from vendors performing services on or for the identified real property. Completion and signature attest that the information provided is true, accurate and complete to the best of Vendor's knowledge and that supporting documentation (licenses, certificates of insurance, references) will be furnished upon request.

Property Identification

Vendor Identification

Entity Type: Corporation LLC Partnership Sole Proprietor Other

Licenses, Certifications & Insurance

Do you maintain Workers' Compensation insurance? Yes No

Certificate of Insurance on file? Yes No

Services Provided

Primary Service Categories (check all that apply): Maintenance Cleaning Landscaping HVAC Roofing Electrical Plumbing Remodeling Security

References

Safety, Incidents & Environmental Compliance

Do you maintain a written safety program and training for employees? Yes No

Any recordable incidents, OSHA citations or material environmental violations in last five years? Yes No

Pricing, Billing & Payment

Conflicts, Affiliations & Legal Matters

Does Vendor or any principal have any affiliation with the property owner, management company, or key personnel? Yes No

Any pending litigation, judgments, criminal convictions, or regulatory actions involving Vendor? Yes No

Representations, Warranties and Indemnity

Vendor represents and warrants that: (a) Vendor is duly organized and authorized to do business in the applicable jurisdictions; (b) all statements in this Questionnaire and any attachments are true, complete and accurate; (c) Vendor maintains all licenses and insurance required by law and by contract; and (d) Vendor will comply with all applicable federal, state and local laws, regulations and ordinances in performing services for the property.

Vendor agrees to defend, indemnify and hold harmless the property owner, manager and their respective officers, directors and employees from and against any and all claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of Vendor's acts, omissions, breach of this Questionnaire, negligent performance of services, or failure to maintain required insurance.

The obligations and representations set forth herein are continuing. Owner may rely on the information provided and may require updated information and certificates of insurance prior to awarding work or continuing a vendor relationship.

Acknowledgment and Certification

By signing below, Vendor certifies under penalty of perjury that the information supplied in this Questionnaire is accurate and complete, that Vendor will promptly notify Owner of any material change to the information, and that Vendor consents to verification of references, licensure and insurance coverage. Vendor further certifies that it will obtain any additional insurance endorsements or naming conventions required by contract and will supply proof prior to performing work.

Vendor acknowledges that false statements or omissions may result in denial of contracting opportunities and may subject Vendor to civil or criminal penalties where applicable.

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