Vendor Application

Company Address(Required)
Are you applying to be a Day-to-Day Vendor or DR Vendor?(Required)
Vendor Type:(Required)
Company Licenses/Certifications (if applicable)
Max. file size: 128 MB.
Are you applying to be a vendor in Puerto Rico?(Required)

Insurance Amount:

Would you be willing to issue a COI with Cat5 as the named insured and obtain endorsements for waiver of subrogation and additional insured on G/L, Auto, Umbrella and waiver of subrogation on Workers Comp?
Are you willing to sign an NDA if required(Required)
Invoice Terms(Required)
**DR Vendor Rates are Net 60
Payments Accepted(Required)