Business & Contractor Network

Contractor Listing Request

Apply to be listed as a verified contractor on the MCHUSA Business & Contractor Network. Applications are reviewed and credentials verified before listing is granted.

I, [name], do hereby state that I am the owner of the undermentioned business and the information submitted is correct and will be used to determine my company's eligibility for a listing on the program. I understand that my information is subject to verification, and this will determine my company's eligibility. During the period of my listing, I will communicate in writing to MCHUSA any material changes which can adversely affect my business operations.

Name of Company

Date Created and Renewal Date

Location of Company and Regions in Which Work Will Be Undertaken

Liability Insurance Company (Amount of Coverage) and Coverage Period

Type of Projects Completed During the Last Five (5) Years and Dates

Names and Contact Information of Project Owners

Upload Your Photo (for use with your listing)

Your photo will be requested separately after your application is received.

Attestation

I confirm that all information submitted in this application is accurate and complete. I agree to MCHUSA's terms for contractor listings and acknowledge that MCHUSA may, at its sole discretion, decline or remove the listing. Listing fees are non-refundable.

I agree to the terms above

Fields marked * are required. Do not include sensitive health information in this form.

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