Vendor Creation Request Form - NAM Info Inc

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Vendor Registration

Vendor Details

Vendor Name

Registered Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Authorized Signatory

First Name

Last Name

Title of Authorized Signatory

Email for sending Contracts

Key Contact Person Name

Email of Key Contact

Phone/Mobile

Federal Tax ID

State of Registration

DUNS Number

Employee Head Count

Are you an ITServe Member?

Yes

No

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