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Business / Contractor Information
Company Name
*
Business Address:
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Phone
*
Email Address
*
Website (if applicable)
Years in Business
*
Number of Employees
*
Type of Business
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Builder
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Primary Contact
Name
*
Position
*
Phone Number
*
Email Address
*
Business Details
Business Structure
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LLC
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Federal Tax Identification Number (TIN/EIN)
*
State Business License Number (if applicable)
Tax Exemption Status (if applicable)
Business References
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Business Reference
Name
Phone Number
Email Address
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Documents Required
Please attach a copy or image of one of the following documents:
• Driver’s License (of the primary contact person)
• Business Card (if available)
• Contractor’s License (if available)
• Federal Tax Identification Number (TIN/EIN)
• W-9
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Accepted file types: jpg, png, pdf, docx, doc, jpeg, Max. file size: 25 MB, Max. files: 5.
Declaration
I hereby declare that all information provided in this application is true and accurate to the best of my knowledge. I understand that Frontier Surfaces may use this information to verify the legitimacy of my business and may contact the references provided.
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Date
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