Vendor Application Form There was an error trying to submit your form. Please try again. Legal Business Name: * This field is required. DBA (if applicable): This field is required. Business Type: Individual LLC Corporation Partnership Federal ID (EIN) (if applicable): If your business operates as a corporation, partnership, or LLC, we require a Federal Employer Identification Number (EIN). This field is required. Social Security Number (SSN) (if applicable): If your business is an individual, we require a Social Security Number (SSN). This field is required. Contact Person * Enter the name of a primary contact person. This field is required. Email Address * Enter the email address of the contact person. This field is required. Phone Number * Enter the contact phone number. This field is required. Physical Address Enter the complete physical address of the vendor. Address Line 1 * This field is required. Address Line 2 This field is required. City * This field is required. State * This field is required. Postal Code * This field is required. Country * Select an option Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of the Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Persian Gulf Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea Korea, Republic of South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Reunion Saint Barthelemy Saint Helena, Ascension and Tristan Da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Yemen Zambia Zimbabwe This field is required. Remit‑To Address (if different): Payment mailing address. Name and address to report on 1099 (if different from above). General Liability Insurance Carrier: * The insurance company that provides your liability coverage in case anything happens while you are performing work. This field is required. Insurance Policy Number: * This field is required. Insurance Expiration Date: * This field is required. Workers’ Compensation Carrier: The insurance company that provides coverage for employee injuries or accidents that occur while performing work. Exemption: Sole proprietor with no employees. This field is required. Insurance Policy Number: This field is required. Insurance Expiration Date: This field is required. I am a sole proprietor with no employees. Service Categories (check all that apply): * Please select the types of services that you provide. Plumbing Electrical HVAC Handyman Pest Control Lawn Care Cleaning Painting Flooring Locksmith Appliance Repair Roofing Tree Service General Contractor This field is required. Service Area: * Provide the areas where you are available to perform services or respond to work orders. This field is required. Emergency / After‑Hours Availability: * Yes No This field is required. After‑Hours Rates (if applicable): The service rates that apply for work performed outside of regular business hours, such as evenings, weekends, or holidays. This field is required. Standard Pricing (optional): This field is required. Preferred Payment Method: * Check ACH This field is required. Name on Bank Account (if ACH): This field is required. Routing Number: Account Number: Do you accept electronic invoices? * Yes No This field is required. References Please provide references from other clients or projects. Submit There was an error trying to submit your form. Please try again.
