Vendor Partner Application

Thank you for your interest in becoming a Bailiwick® Vendor Partner. We believe the best way to begin a potential partnership is to learn as much as we can about your business and your capabilities.

We review applications on a monthly basis for areas of need and overall potential fit based on responses provided in the application. As a result, not all applications will receive a response.

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Corporate Office

Company Name *

Address *

City *

State / Provence *

Zip Code / Postal Code *

Website / URL

Business Contact Name *

Business Contact Phone Number *

Business Contact Email *

Other Locations / Offices

Union Affiliation *

IBEW
CWA
IBEW & CWA
Non-union

What % of your annual revenue is from national providers such as Bailiwick? *

Please provide an overview of your organization and its history. *

Please provide an overview of the most common type(s) of work your company performs. Be detailed and this is not meant to be all inclusive of your skills, rather the work you perform with the most frequency. *

At the time of onboarding, Bailiwick requires our Vendors be on direct deposit for payments. Is your company willing to do direct deposit? *

Yes, we will use direct deposit

List all relevant certifications your company holds *

Are you fully licensed to conduct all aspects of your trade in the states you operate in? *

Does your company have a written Safety Program? *

Details on your safety program *

Does your company have a written Quality Control Program? *

Details on your quality control program. *

Use of Bailiwick’s field app is a requirement for all technicians to upload deliverables. Is your company willing to use the app to complete Bailiwick work? *

Yes, we will use the Bailiwick field app

How did you hear about us? *

Bailiwick Employee
Client
Existing Bailiwick Labor Partner
Material Supplier
Social Media
Website / Blog
Other

Which Social Media?

Do you have a name, URL, or other details?

If you have any additional details on your referal, please place them here.

COI Insurance Requirements

The following insurance requirements are required of all vendor partners.

General Liability ($1,000,000 each: General Aggregate, Personal Injury, Completed Work & Products, & Per Occurrence coverage)
Auto Insurance ($1,000,000 coverage)
Workers Comp / Clearance Insurance ($100,000 – $500,000 – $100,000 coverage)

Checkboxes *

By checking this box you agree to meet the insurance requirements.

Personnel

Number of W2 Technicians *

Do you perform drug screening as a condition of employment?

It is our preference you are able to answer yes to the drug & background requirements, if not we MAY not reach out to you.

How many drugs do you screen and at what panel level? *

Do you perform regular follow-up drug screening tests for existing employees (either randomly or at regular follow-up intervals)? *

Do you perform background checks as a condition of employment? *

Do your background checks look back at least 7 years? *

Do your background checks include at least the following items: criminal history, driving record, name/address validation, professional license verification search? *

Do you perform criminal background follow-up checks for existing employees (either randomly or at regular follow-up intervals)? *

What type of work are you looking for? *

Digital Signage Installation
General / Low Voltage

Skill Capabilities

Check all capabilities you offer.
All rates in U.S. Dollars($) and should assume standard daytime dispatch Rates entered may impact our response.

Checkboxes

Standard Low Voltage Tech (any low voltage tasks, including cabling, POS or Network device installation, CCTV)
Electrician (If applicable)

Standard Low Voltage Tech Rate *

Electrician Rate *

Digital Signage Questions

All of our projects require our Vendor Partners to be able to self-perform outdoor menu boards/sign settings. By checking this box you are confirming you can do this.

Yes odmb *

Yes, I can self-perform outdoor menu boards/sign settings

Can you self-perform installing concrete foundations? *

Can you self-perform excavation? *

Are you capable of terminating Cat 5/6 cable and testing it? *

Has your company completed drive thru menu board installation work in the past? *

Please provide a description of the work you have done (quantity, type, scope, customer). *

How would you classify your core business? *

Sign Installation Only (setting sign and terminating low and high voltage)
Turnkey Sign Installation (earthwork, concrete, and sign installation)
General Contractor (you can subcontract multiple scopes to complete a project while self-performing some)
Other, not listed

Please explain your core business

Other information you would like to share?