Affiliate Vendor Screening Questionnaire


Thank you for your interest in subcontracting with Favorite Healthcare Staffing. Please answer the following screening questions to determine if you meet our minimum requirements.

Have you been in business for at least 12 months?*
Yes No
Do you assume sole responsibility as the employer of record for the payment of wages to your temporary employees (W2) and for the withholding of applicable federal, state and local income taxes, the making of required Social Security tax contributions, and the meeting of all other statutory employer responsibilities (including, but not limited to, unemployment and worker’s compensation insurance, payroll excise taxes, etc.)?*
Yes No
Do you maintain general liability insurance and professional liability insurance with limits equal to or greater than $1,000,000 per occurrence and $3,000,000 aggregate and will provide certificates of insurance naming Favorite Healthcare Staffing, Inc. as an additional insured?*
Yes No

* Indicates required fields


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