First Allegiance Contractor Registration

Company Information

Company Name *

Tax ID # *

OR SS #*

Contact Information

Email Address *

Note: Once registered, you'll receive email with link to set your password

Confirm Email Address *

Contact Person *

Phone# *

Exp.

Cell Phone # *

Opt-in to receive transactional text messages from First Allegiance Property Services, Inc.

Address Information

Location Name *

Zipcode *

Address Line 1*

Address Line 2

City *

State *

Mailing address if different

Check if it is same as address.

Mailing Zipcode

Mailing Address 1

Mailing Address 2

Mailing City

Mailing State

Other Information

No. of Employees *

Years in Business

How did hear about First Allegiance?

Have you ever done work for First Allegiance in the past?

Yes No

Are you or is your company a member or affiliate member of NAREB (National Association of Real Estate Brokers)? *

Yes No

NAREB (National Association of Real Estate Brokers) is the oldest and largest minority real estate association in America. It is comprised principally of African-American and other minority real estate professionals, however, the organization is an integrated entity open to all qualified people and organizations. First Allegiance has been an affiliate member of NAREB for many years and supports NAREB membership.
To become a member Click Here

Verification

Type the word shown below image *

Additional Contact

No	Contact Person	Email	Do not Have Email	Phone	Cell Phone
1				Ext.
2				Ext.
3				Ext.

After Registration you can give web access to your contact person from your acount.

General Liability Insurance Information

Insurance Company Name

Insurance Agent Name

Phone Number

Policy Number

Ext.

Insurance expiration date

Limits

First Allegiance listed as additional insured on insurance certificate.
Certificate Not Available

Upload Certificate

Workman's Compensation Insurance Information

Insurance Company Name

Insurance Agent Name

Phone Number

Policy Number

Ext.

Insurance expiration date

Limits

Certificate submitted under General Liability Insurance
Exempt Insurance

Upload Certificate

Contractor Business License Information

License 1

License Number *

Issued By *

License Level

State County City

License does not have an expiration date.

License Expiration Date *

License

Sign :
Title :
Company Name :
Diversity Self-Certification Date :
Vendor Identification Number :