Sub Contractor & Vendor Registration

Accounting open: 9am – 5pm

  • Registration Type:
    Sub ContractorVendor
  • Company Name:
  • Year Company Established:
  • Company Type:
    CorporationPartnershipSole ProprietorshipIf other, please specify type:
  • Address:

  • Phone:
  • Email:
  • Tax Identification Number (TIN):
    (must be 9 digits)
  • If Sole Proprietor (Withholding, 1099) enter your SSN in lieu of the TIN:

    Work Performed By Your Company

  • Sitework:
    FencingGeneral SiteworkPavementLandscapingBuilding DemolitionCurbs & Walks
  • Thermal & Moisture Protection:
    RoofingSpray on FireproofingJoint SealantsMetal Wall PanelsDamproofing & WaterproofingSiding Panels
  • Finishes:
    EIFSGypsum Drywall/CeilingsCeramic TileResilent Tile Flooring/CarpetPainting & FinishingStain Concrete
  • Mep:
    SprinklerPlumbingHVACElectricAV Systems
  • Security:
    Detention Equipment & SystemsSecurity Hollow Metal/HardwareSecurity Glazing/WindowsElectronic Security Systems
  • Concrete & Masonry:
    Concrete WorkMasonry WorkPrecast Concrete
  • Doors & Windows:
    Door Frames & HardwareRoll Up DoorsGlass & Glazing
  • Specialties:
    Wire Mesh PartitionsWindow TreatmentsLouvers
  • Conveying Systems:
    ElevatorsWheelchair Lifts
  • Metals:
    Structural SteelMiscellaneous Metals
  • Wood & Plastics:
    Architectural Woodwork
  • Equipment:
    Kitchen Equipment
  • Other:

    Contact Information

    Sales Representative
  • Name:
  • Title:
  • Phone:
  • Email:
    Account Manager
  • Name
  • Title:
  • Phone:
  • Email:

    ACH Information

      Check here if your company does not have the ability to complete ACH transactions.

    If you would like to set up electronic ACH payments, please complete the section below:


  • Name of Bank:


  • Branch Name and Location:


  • Bank's ACH Coordinator:


  • Bank's ACH Coordinator Phone:


  • Vendor Name (as it appears on account):


  • Branch Name / Branch ID #:


  • Bank Account #:


  • Account Type:


  • Transit Routing # (must be 9 digits):

    Company MBE/WBE/Section 3 status

  • Is the company Minority Owned?

    YesNo
  • Is the company Woman Owned?
    YesNo
  • Does your company qualify as a Section 3 Vendor under HUD's Section 3 Act of 1968?
    YesNo
  • For details click, HUD's Section 3 program.

    Consent

    By clicking here, I certify that I am authorized to supply this information and that all the information provided is true to the best of my knowledgeName:

    Must include the following enclosures when returning this form to The New Modern Home™.
       - A completed and signed W9 form.
       - Copies of any applicable MBE or WBE certification.