Contractor Registration Form - Brink Riley Student Living

Company Details

Please list other trades not listed *

Areas covered *

Company Name *

Limited CompanySole Trader

Company Registration Number *

YesNo

VAT Number *

UTR Number *

Street Address *

Apartment, suite, etc

City *

State/Province

ZIP / Postal Code *

Country

Contact Person *

Email Address *

Telephone *

Website

Public/Employers liability insurance *

Health and Safety Statement

No file chosen

Gas Safety Registration Certificate *

No file chosen

NICEIC Registration Certificate *

No file chosen

Waste Transfer License *

No file chosen

Any other supporting documents

Reference 1 Name

Reference 1 Email Address

Reference 1 Phone

Reference 2 Name

Reference 2 Email Address

Reference 2 Phone

Upload any references here

Signature

Date