This form is designed to gather essential information needed by RigNation.com to assess your eligibility for the Service Provider program. Roadside service providers, including towing companies, roadside repair, and similar businesses, are invited to complete the Independent Service Provider Application Form provided below.

business information

heavy duty towing

$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$

Payment Methods

Hours of Operation

Notes

(Write any additional notes you may have in the field provided below)

Signature

Thank you for submitting your bid to Rignation.com

in order to be a provider of services for rig nation you are to provide us with proof of insurance coverage as well as a signed acknowledgement that you and your company have a duty to defend rig nation and hold us harmless from any actions that occur or arise during the performance of your duties on those customers that rig nation provides to you.

please sign below to acknowdge and agree to the above statement: