Vendor Partner – Small Business Contact Information Business Business Website/URL (LinkedIn) Primary Contact * Primary Contact First First Last Last Date * Federal Tax ID * Email * Primary Phone * Other contact numbers (after hours, etc.) Primary Billing Address * Primary Billing Address Primary Billing Address Primary Billing Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country Background/Drug Screenings * Yes No COVID Vaccinated Technicians * Yes No Are you available for after-hours, weekend and/or holiday calls? * Yes No Total Number of Technicians * Skills Technical Capabilities * AUTOMATED TELLER MACHINES BARCODE PRINTER SKILLS BASIC NETWORKING SKILLS BASIC PC SKILLS BASIC PRINTER SKILLS BASIC SIMPLE SWAP CABLING SCISSOR LIFT OPERATION AV CABLES PULLING AV CABLES QUOTES & ESTIMATES AV CABLES TERMINATING AV SURVEY & INVENTORY INSTALL AV EQUIPMENT ETHERNET PULLING ETHERNET TERMINATING ETHERNET QUOTES & ESTIMATES ETHERNET SURVEY & INVENTORY FIBER OPTIC PULLING FIBER OPTIC TERMINATING FIBER OPTIC QUOTES & ESTIMATES FIBER OPTIC SURVEY & INVENTORY RACK SERVER, REPAIR/INSTALL ELECTRICAL LICENSE HIGH VOLTAGE, 110V/220V CONCRETE DRILLING CUSTOM FIXTURE FABRICATION DRILLING WALLS, COUNTERS, SURFACES MOUNTING AND REPAIRING DRYWALL IBM MAINFRAMES (TERMINALS, PTR) KIOSK EXPERIERCED LAPTOP SKILLS LINUX SKILLS MCSE CERTIFIED CE MULTI-FUNCTION PRINTER MID-RANGE SYSTEMS ADVANCED NETWORK SKILLS NETWORK & SYSTEMS ENGINEER PRINTER – HIGH SPEED ADVANCED PLOTTER SKILLS POINT OF SALE DEVICES PROJECTORS SCANNER, IMAGING UNITS Large STK and IBM Silos ADVANCED SERVER SKILLS STORAGETEK REPAIR SKILLS SUN MICROSYSTEMS DEVICES TELEPHONY UNIX OS SKILLS UNINTERRUPTABLE POWER SUPPLIES WAM WEIGHTS AND MEASURES CERTIFIED Certifications Attachments Corporate Overview * Drop a file here or click to upload Choose File Maximum upload size: 67.11MB If you are human, leave this field blank. Next Start Over Return to Vendor Partners
