Allied Fire Protection

Vendor Information Form

Company Name(Required)

Type of Service or Material Provided(Required)

Billing Terms(Required)

Vendor Type(Required)

Certificate of Insurance (COI)(Required)

Max. file size: 2 MB.

Once the required information has been submitted, an Allied Master Subcontract Agreement (MSA) will be issued and must be fully executed before the Subcontractor may begin work on any Allied jobsite.

General Liability Insurance(Required)

YES

If yes, a copy of your certification of insurance must accompany this form.

Certification of General Liability Insurance(Required)

Accepted file types: pdf, Max. file size: 2 MB.

Workman’s Compensation Insurance(Required)

YES

If yes, a copy of your certification of insurance must accompany this form.

Certification of Workman’s Compensation Insurance(Required)

Accepted file types: pdf, Max. file size: 2 MB.

Master Construction Subcontract Agreement (MSA)(Required)

Accepted file types: pdf, Max. file size: 2 MB.

Tax ID(Required)

W-9(Required)

Accepted file types: pdf, Max. file size: 10 MB.

Physical Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Main Office Phone(Required)

A/R Contact Name(Required)

A/R Contact Phone(Required)

Remittance Email(Required)

Remittance Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Who at Allied Fire Protection requested you update this form?

This form will not be process without this information.

Name(Required)

Title(Required)

Email(Required)

Phone #(Required)

Signature(Required)

Print Name(Required)

Title(Required)

Date(Required)