Contractor Intake Form
HouseMaster Chattanooga — Neutral Resource List Candidate Submission
Compiled:
2025-10-15
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Company Information
Legal Business Name
*
DBA (if different)
Primary Contact Name
*
Title/Role
Contact Email
*
Phone
*
Company Website
Years in Business
Service Area (cities/counties)
Trades & Services
Primary Trades (check all that apply)
*
Roofing
Electrical
Plumbing
HVAC
Foundation / Structural
Drainage / Waterproofing
Masonry
Siding / Windows / Doors
Sewer / Drain
Chimney / Fireplace
Pest / Termite
Mold / IAQ
General Contractor / Handyman
Radon
Water Quality / Well
Other
If “Other” is selected, please specify below.
Other Trade(s)
Typical Lead Time (weeks)
24/7 Emergency Service?
No
Yes
Warranties Offered (brief)
Certifications (NATE, IICRC, NADCA, etc.)
Licensing
License Type
License Number
*
State
Expiration
Upload License Proof (PDF/JPG/PNG)
*
Insurance
General Liability Carrier
GL Policy #
GL Expiration
Per Occurrence Limit ($)
Aggregate Limit ($)
Upload Certificate of Insurance (PDF/JPG/PNG)
*
Include Workers’ Comp proof if applicable.
Workers’ Comp Carrier
WC Policy #
WC Expiration
Upload Workers’ Comp Proof (optional)
References
Client/Company Name
*
Phone
Project Type
Year
Permission to contact this reference
Client/Company Name
*
Phone
Project Type
Year
Permission to contact this reference
You may provide more references via email or in a combined PDF with other documents.
Additional Documents
Upload W‑9 (optional)
Other Supporting Docs (optional)
Attestations & Signature
I certify the information provided is accurate and complete.
I authorize HouseMaster Chattanooga to verify licensing, insurance, and references.
I understand submission does not guarantee inclusion on any resource list.
Typed Signature (full legal name)
*
Title
Date
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