Lone Star Vendor Registration Form

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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 IdSocial Security NumberBoth
Tax Id
Social Security Number
Company name *
Contact Information
Home Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Emergency Contac Number
Please enter a valid phone number.
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*

General ContractorHandyman ServicesCarpentryPlumbingElectricalLandscaping & IrrigationPest Control/ ExterminationGeneral RemodelingPainterHVACRoofingPavement & DrivewaysLocksmithOther
Do you have a contractor's license?

YesNo
Do you carry current business/liability insurance?

YesNo
Do you have a current bond?

YesNo
Do you have employees?

YesNo
Do you use other licensed contractors?

YesNo
Do you carry current workman's comp?

YesNo
Business insurance name*
Insurance Phone Number*
Please enter a valid phone number.
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.
Relationship*
Reference 2
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Reference 3
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Reference 4
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
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

Clear
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