Vendor Registration Application

Vendor Registration Application

WHEREAS: The Applicant desires to be registered as a vendor to provide goods and/or services to the Company; and

WHEREAS: The Company requires accurate business, tax, insurance and compliance information for evaluation and onboarding; and

WHEREAS: The Applicant certifies that the information provided herein is true, complete and subject to verification, and agrees to the terms and conditions set forth in this Application and any subsequent vendor agreement.

1. Vendor Information

Business Name:

Entity Type: Sole Proprietor Partnership Corporation LLC Nonprofit

Federal Tax ID / EIN / SSN:

2. Primary Contact

3. Scope of Work / Goods & Services

Primary Category: Goods / Supplies Services / Labor Consulting Other

4. Payment Terms & Remittance

Standard payment terms to which the Applicant agrees: invoices submitted in accordance with the purchase order or contract will be paid in U.S. dollars within the agreed payment period. Unless otherwise agreed in writing, the Company's default payment terms are Net 30 days from receipt of a correct and undisputed invoice. Late payments may accrue interest or a late fee as set forth below.

Preferred Payment Terms:

Remittance Method: ACH / Electronic Transfer Check Card

5. Insurance, Certifications & Regulatory Compliance

The Applicant represents and warrants that it maintains insurance appropriate to the goods and/or services provided and will provide certificates of insurance upon request. Applicant agrees to maintain such insurance in force for the duration of any engagement.

Insurance Coverage: General Liability Workers' Compensation Professional Liability Umbrella

6. Compliance, Confidentiality & Indemnity

Compliance with Law: The Applicant shall comply with all applicable laws, rules and regulations in performing services or delivering goods, including, without limitation, labor, environmental, export control and tax laws. Applicant shall maintain truthful records and permits and shall provide copies upon request.

Confidentiality: Applicant acknowledges that it may receive confidential or proprietary information. Applicant agrees to maintain confidentiality, use such information only for performance of contracted services, and not disclose it without the Company's prior written consent. This obligation survives termination of any engagement.

Indemnification: Applicant shall indemnify, defend and hold harmless the Company, its affiliates and their officers, directors and employees from and against any claims, damages, losses, liabilities, fines and expenses (including reasonable attorneys' fees) arising out of Applicant's breach of this Application, negligent acts, willful misconduct, or failure to comply with applicable law.

Anti-Corruption: Applicant represents and warrants that it has not and will not, directly or indirectly, offer, promise or give any undue or improper advantage to any public official or private person in connection with the performance of services.

By checking the box below and signing this Application, Applicant certifies that all information provided is true, complete and accurate to the best of Applicant's knowledge; that Applicant understands submission of false information may result in rejection or termination from the vendor list; and that Applicant agrees to the terms set forth herein.

I certify the information in this application is true, accurate and complete and I agree to the terms above.

7. Term and Termination

Term: Registration becomes effective upon acceptance by the Company and remains in effect until terminated by either party. The Company may remove the Applicant from the vendor list at any time for cause.

Start Date:   End Date (if applicable):

Termination Notice Period (if required):

8. References

9. Governing Law & Entire Agreement

Governing Law: This Application and any subsequent contractual relationship arising from it shall be governed by and construed in accordance with the laws of the state governing the Company's procurement policies, without regard to principles of conflicts of law.

Entire Agreement: This Application, together with any referenced purchase orders, contracts or attachments, constitutes the entire agreement between the Applicant and the Company with respect to vendor registration and supersedes all prior and contemporaneous communications, whether oral or written, relating to the same subject matter.

10. Applicant Signature and Authorization

The undersigned represents and warrants that they are authorized to submit this Vendor Registration Application on behalf of the Applicant and that the Applicant agrees to the terms and conditions set forth herein.

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