1. Applicant’s legal name, business name, address, telephone and facsimile numbers:
Registered Legal Name
Business Name
(if different from above)
Address
Tel:
Fax:
2. Applicants GST and WCB Number:
GST Number
WSIB Number
3. Applicants Insurance Liability coverage: Value by Type of Coverage
General Liability $
Automobile Liability $
Theft and Dishonesty $
4. Name, position/title, address, telephone, facsimile numbers and e-mail address of the contact person(s) for the Applicant (the person primarily responsible for the Application):
Name
Position/Title
Address
Tel:
Fax:
Email Address
5. Applicant’s company security information:
Current Level of Security Clearance (Through PWGSC (CISD) only)
None, Reliability, Secret (select one)
If None, please confirm your organization's willingness to begin the clearance process.
6. Applicant’s company information:
Number of personnel employed by Applicant
Geographic location(s) from which services are provided
Area(s) of recognized expertise in the market
7. Please indicate whether your workforce is unionized and which unions apply
8. Scope of work: please indicate from the list all scopes that you are able to support.
9. Please include any additional information that you feel may be relevant.
