Contractor Application Form

I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in said documents will be cause for denial of entering into a contract with Maxim Enterprises regardless of the timing or circumstances of discovery. I understand that submission of an application does not guarantee you will be offered contractor agreement with Maxim. I understand that if offered a contractor agreement with Maxim Enterprises I may be required to submit to a pre-contract background check as a condition of entering into a contract. I understand unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-contract background checks will result in withdrawal of any contract offer or termination of contract if already under contract. I herby authorize any and all schools, former employers, references, courts and any others who have information about me to provide such information to Maxim Enterprises and/or any of its representatives, agents or vendors and I release all parties involved from any and all liability for any and all damage that may result from providing such information. I understand that this application is considered current for three months. If I wish to be considered for contractor servcies after this period I must fill out and submit a new application. BY SUBMITTING THIS FORM I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE STATEMENTS.

*I agree: