Business Application — Block Friendly

1. Business identity

The legal entity that holds your license and insurance.

Legal business name *

DBA / trade name

Entity type *

EIN (Federal Tax ID)

Years in business

Website

2. Operational address

The address on your license and insurance. Must match Polk County records.

Street address *

Suite / unit

City *

State *

ZIP *

Business phone *

3. Owner / authorized contact

We'll call this person to confirm details before your listing goes live.

Full name *

Role / title

Email *

Direct phone *

4. Licensing

We verify your license number against the issuing authority's public records.

License number *

License type *

Issuing authority *

Expiration date

Upload license (PDF or image)Click to choose a PDF or image (max 10 MB)

5. General liability insurance

Upload your Certificate of Insurance (COI) showing active general liability coverage.

Insurance carrier *

Policy number *

Coverage amount

Expiration date

Upload Certificate of InsuranceClick to choose a PDF or image (max 10 MB)

6. Service details & listing tier

Tell us what you do and where. We'll recommend the best tier for your reach.

Service categories *

Service area ZIP codes *

Requested listing tier *

Anything else we should know?

7. Attestation

Block Friendly manually verifies every applicant. By submitting this form you certify that all information is true and accurate, and you authorize Block Friendly to verify your license and insurance with the issuing authority and carrier.

Your information is encrypted in transit and at rest, used solely to verify your business, and never sold or shared with third parties.

Type your full name to sign *

I certify the information above is true and accurate, and I'm authorized to submit this application on behalf of the business.

Verification typically completes in under 24 hours.

Apply to advertise on Block Friendly