Upload your Certificate of Insurance
Upload your W-9
Upload your Contractors License
Legal Entity Name
Business Name/Disregarded Entity Name, If Different From Above
Mailing Address
City, State, Zip
Physical Address
Physical City, State, Zip
Phone
Website
Authorized Signer 1: Name and TitlePlease list all persons authorized to sign on behalf of your company.
Authorized Signer 1 Email
Authorized Signer 2 Name
Authorized Signer 2 Email
Authorized Signer 3 Name
Authorized Signer 3 Email
Email Address for Invitations to Bid
Email Address for Invoicing & Accounts Receivables
Email Address for Purchase Orders and Subcontracts
Contact Name for Purchase Orders & Subcontracts
Business Type
Subcontractor, Labor Only Supplier, Materials Only Turnkey Subcontractor, Labor & Materials Consultant (Architect, Engineer Etc.)
Louisiana Contractors License #
Louisiana Sales TaxPlease Select From The Dropdown Menu.
I will collect and remit sales tax on items sold to your firm. I will not be collecting or remitting sales tax on items sold to your firm.
Local Sales TaxPlease Select From The Dropdown Menu.
I will collect and remit local taxes on items sold to your firm. I will not be collecting or remitting local taxes on items sold to your firm.
My Scope of Work Includes:Please list the scopes, trades, or divisions of work that your firm provides.
Email Address of the Person Filling Out This Form
SUBMIT FORM
