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Full Legal Name of Business Entity
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Federal Tax ID (FEIN)
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Phone Number
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Doing Business As (DBA)
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Billing Address
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Street Address
City
State / Province / Region
ZIP / Postal Code
Company Type
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Corporation
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Briefly Describe What the Company Does
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Number of Employees
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Year Business Established
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Website
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Have you visited the facility?
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Is there machinery exposure?
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Yes
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If yes, describe the machinery?
What training does the Staffing Company/MForce provide?
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Is PPE required for any of the job duties?
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Yes
No
If yes, that what equipment is required, who will supply and will it be enforced for all workers with a written discipline policy in place?
Placement Type
Direct
Contract
Contract to Hire
Fee (ex. $25,000)
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Weekly Bill (ex. $500)
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