Lone Star Vendor Registration Form

Join Our Vendor Network

THE FOLLOWING INFORMATION ON THIS PAGE IS REQUIRED IN ORDER TO PROCESS THE APPLICATION
Company Contact Information
Point of contact name

First NameLast Name
What Will you be submitting?
Tax Id
Social Security Number
Company name
Contact Information
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contac Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Company Information
What Type of Work Does Your Company Do? Please Fill Out Detail On The Following Options

Other
Do you have a contractor's license?
Do you carry current business/liability insurance?
Do you have a current bond?
Do you have employees?
Do you use other licensed contractors?
Do you carry current workman's comp?
Business insurance name
Insurance Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How much do you carry in bonds?
Workman's comp company
References

Please list references below
Reference 1
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Reference 2
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Reference 3
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Reference 4
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Download W9 here
Please upload W9 form here

Cancelof
Certificate of Liability Insurance (COI) issued to Lone Star Community Management, LLC

Cancelof
Commercial auto Insurance/Coverage

Cancelof
Which Areas Would You Like to Service?
Enter the ZIP Codes, cities, or zones where you are available to work
Date of Submission

MonthDayYear
Date
I hereby affirm that all information provided above is accurate to the best of my knowledge and belief, and I understand that this information will be considered material in the evaluation of quotations, bids and proposals.
Date

MonthDayYear
Date
Company Representative Signature
Should be Empty:

Join Our Vendor Network

Company Contact Information

Contact Information

Company Information

References

Reference 1

Reference 2

Reference 3

Reference 4

Download W9 here