New Vendor Submission

Who is filling out this form? *

The Vendor Employee/Agent Property owner

Did the property owner request the use of this vendor? *

Yes No

Property owner's email address *

Required when you are the property owner, or when an employee submits and the owner requested this vendor.

The property owner may be charged a $100 vendor screening fee after submission. You must confirm the owner is aware and has approved. I confirm the owner is aware and has approved. *

I understand the $100 screening fee is not refundable if the vendor does not meet Revolution requirements. *

This vendor cannot be used on current work orders; only after Revolution screens and approves. *

Revolution only approves vendors who provide a W-9 and insurance meeting our policy (minimum GL / workers comp as stated in the insurance section). *

High-priority work (HVAC, leaks, no hot water, etc.) is expected in under 3 days; other work in under 6 days on average. *

Your email *

Your phone *

Vendor name *

Vendor street address *

Address line 2

ZIP *

Vendor email *

Vendor website

Vendor type *

Describe vendor type *

State(s) where the vendor will do business for Revolution *

Georgia Florida

When doing business in both states, which state is primary for this vendor? *

Georgia Florida

Vendor's service area (ZIPs, cities, or counties) *

Do you have a copy of the vendor's IRS Form W-9? *

Yes No

Our Bookkeeping Department will have to obtain a copy of the 1099 from the vendor before this vendor can be used. This vendor cannot be scheduled for any work until this is obtained.

Upload W-9 *

PDF or image. Max 25 MB.

Vendor agrees to net 30 payment terms (Revolution typically pays vendors weekly on Fridays; payment may take up to 30 days). *

Insurance: vendor must carry general liability ($1M) and workers compensation ($500k) as required; sole proprietor exemption does not waive this for Revolution vendors. Vendor meets these insurance requirements. *

The insurance certificates must be uploaded for Revolution's records. If you have both general liability insurance and workers' comp insurance on a single insurance certificate, then attach the same certificate in both fields below.

WARNING: Submitting insurance certificates that are missing the required insurance will result in immediate denial. Revolution will not follow up to collect documents, so be sure to submit the correct documents when submitting this form.

Upload certificate of general liability insurance *

Upload certificate of workers' compensation insurance *

Revolution requires that all vendors receive payment by direct deposit/ePayment. We do not issue paper checks. Please provide the following direct deposit information.

Bank name *

9-digit routing number *

Account number *

Billing address — street *

Billing address — line 2

ZIP *

Type your full legal name *

I agree this is my electronic signature. *

Company website