Vendor Renewal Application

1
Name of Principal Owner* This field is required.
First Name
Last Name
2
Principal Owner Phone Number* This field is required.
3
Principal Owner Email Address* This field is required.
4
Email Address for Request for Proposals (RFP)* This field is required.
5
Additional Contact Name
First Name
Last Name
6
Additional Contact Phone Number
7
Additional Contact Email Address
8
Business Legal Name* This field is required.
9
Website
10
DBAs / Tradenames (other than business names)
11
Legal Business Address* This field is required.
12
Line 2
13
City* This field is required.
14
State* This field is required.
15
Zip Code* This field is required.
16
Certificate of Insurance (COI)* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
*** Please note you will be required to submit your COI annually to prevent payment delays.
Cancelof
17
W-9
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
*** Please note you will be required to submit your W-9 annually to prevent payment delays.
Cancelof
18
Are you currently registered with the BBB?
Yes
No
In Progress
19
Would you like to renew being placed on Rj Community Management's preferred Vendor List? (an annual fee of $50 must be submitted)
Yes
No
20
Vendor Advertisement Renewal
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My Bag
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My Bag
Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
Total costUSD
Vendor Website RenewalVendor website advertisement renewal
$50.00+Edit
Back
Total cost $0.00
Credit Card
First Name
Last Name
Should be Empty: