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Service Provider Application
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 Service Provider Application
 
To be a Service Provider for American Home Shield, you must be a licensed contractor for the trades you service, carry $500,000 in General Liability Insurance and provide proof of Workman's Compensation Insurance or a waiver thereof (if self-employed). In addition, you must have proof of auto insurance in the amount of $100,000 per person and $250,000 per occurrence.
 
All fields marked with an * are REQUIRED.
 
* Trade :  
* Company Name :

 

* Company Address :  
* City :  
* State :  
* Zipcode :  
* Company Contact Full Name :  
* Business Phone Number :  
Ext :  
* Email Address :  
General Liability Insurance Policy # :  
Insurance Carrier :  
* Contractor's License # :  
* Auto Insurance Policy # :  
Additional Information :