P4 Vendor Approval Application/Vendor Change
Requesting Vendor Section
Date Requested
-
Month
-
Day
Year
Date
Type
*
Please Select
New Vendor
Changes to existing vendor
Delete
Other
Department
*
Please Select
Sales
Service
Parts
Recon
Collision
P4
Other
Store/Stores Needing Vendor Set Up
*
COC
FOC
NOC
CDJR/Hyundai
Stoops
Mann's
Recon/Collision
P4
Leo Chevy Indy
Leo Chvey/GMC
Store Manager Requesting Set Up:
*
Company Name
*
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is address the same as the physical?
*
Please Select
Yes
No
Remit to Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Main Point of Contact
*
First Name
Last Name
Direct Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address of Main Point of Contact
*
example@example.com
Billing Point of Contact
*
First Name
Last Name
Email Address of billing point of Contact
*
example@example.com
Items that MUST be turned in with Vendor Application(Required for ALL)
Upload Completed W-9 with Tax Id Information
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload Copy of Insurance Card if they will be driving our vehicles
Browse Files
Drag and drop files here
Choose a file
Cancel
of
What Service Does this Vendor Provide?
*
Submit
Approval Section
All Information Loaded in DT(including Tax Information)
Vendor Sent Compliance Acknowledgement Form
Date Compliance Form Sent
Approved By
Estimated Annual Expenditures
Submit
Should be Empty: