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.
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: