Supplier Network Form

Step 1 of 8

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Supplier Type*

Surveyor

Contractor

Please indicate the core services you provide as a business. These services should be ones you are comfortable handling in isolation for your entire coverage area

Tick which services you offer*

Claim Validation

Drone Surveys

Do you provide the following services?

Please indicate the core services you provide as a business. These services should be ones you are comfortable handling in isolation for your entire coverage area.

Tick which services you offer*

Alternative Accommodation

Arborist

Asbestos Sampling/Removal

Bicycle Validation and Repair

Brickwork

Building Repair

Caravan Repair

Caravan Validation

Contents

Drainage – Mains

Drainage – Off Mains

Electronics Repair

Flooring Restoration/Replacement

Glass/Glazing Replacement

Jewellery

Leak Detection

Make Safe

Oil Cleaning/Removal

Out of Hours Emergency Repairs

Reactive Response Repairs

Restoration (Drying)

Storage & Removal

Strip Outs

Structural Engineer

Subsidence Investigation

Subsidence Monitoring

Subsidence Substructure Repair

Tarmac/Imprinted Concrete Replacement

Textiles Restoration

Trace & Access

Water Supply

Specialist/Other

Specialist / Other Details*

Minimum Project Value

Maximum Project Value

Please indicate any additional services you offer as a support when you are instructed for your core services i.e. please select storage if you can store limited items while undertaking strip out and reinstatement work etc.

Tick which services you offer

Asbestos Removal

Asbestos Sampling

Drone Surveys

Glass & Glazing

Leak Detection

Out of Hours Emergency

Restoration (Drying)

Storage / Removals

Specialist/Other

Specialist / Other Details*

Have you worked previously for a company of Claims Consortium Group?*

Yes

General Information

Company Name*

Trading Name (if different)

Main Contact*

Main Contact Job Title*

Main Contact Email*

Main Contact Telephone*

Office Telephone Number*

Office Mobile Number

Office Email Address*

Website

Company Reg Number

VAT Number

Addresses

Trading Address

Name or number of building*

Street*

Town*

City*

County*

Postcode*

Registered Address

Name or number of building*

Street*

Town*

City*

County*

Postcode*

Coverage Area & Availability

Primary postcode regions coverage for normal working hours*

Secondary postcode regions coverage*

Are you available to work outside of these parameters for an additional payment? e.g. emergency work/weekends/extended distances?*

Yes

Additional Information

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