Superior Workforce Solutions MSP Registration

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1. Please provide your company information

Primary PoC First Name

Primary PoC Last Name

Primary PoC Title

Primary PoC Email Address This question requires a valid email address.

Secondary Contact

Legal Company Name

Street Address

City

State

Zip

Phone Number

Fax Number

Is location listed your company's Corporate Headquarters?

Please list any additional physical office locations (city, state, and zip):

2. Year Incorporated: This question requires a valid number format.

3. Type of company:

4. Please indicate what if your organization is certified in any of the following areas:

Small Business Concern (SB)
Small Disadvantaged Business Concern (SDB)
HubZone Small Business Concern (HUBZ)
Women-Owned Small Business Concern (WOSB)
Veteran-Owned Small Business Concern (VOSB)
Service-Disabled Veteran-Owned Small Business Concern (SDVOSB)
Native American Indian
Minority-Owned Business

5. Upload Status Certificate

File: {{filename}} delete

6. What is your company Dun & Bradstreet number?

7. What is your Federal Tax ID? *This question is required.

9. If Yes, please provide level and CAGE code.

10. Has your company ever filed any bankruptcy proceeding? *This question is required.

11. Do you work with a payroll funding company? *This question is required.

12. What is the number of billable contractors your company placed last year?

13. What is the number of direct placements your company made last year?

14. 3rd Party Contractors

Does your company allow 3rd party contractors?

If Yes, please describe your subcontracting policy.

15. Vendor Management System (VMS)

Does your company own a Vendor Management System (VMS) tool?

If Yes, please provide the name.

16. Please provide your current insurance coverage per category: *This question is required.

General Liability
Umbrella
Automobile
Professional Liability