Vendor Partnership Application Contact Information Business/Name Business Website/URL or LinkedIn Primary Contact * Primary Contact First First Last Last Date * Federal Tax ID or SSN * 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 AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Technician/Rate Information 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 * Base Rate ($) * Travel Rate ($) * Travel Radius From Home Location Unpaid (Miles) * Travel Radius From Home Location Paid (Miles) * Skills Likert Scale * Yes No AUTOMATED TELLER MACHINES * Yes No BARCODE PRINTER SKILLS * Yes No BASIC NETWORKING SKILLS * Yes No BASIC PC SKILLS * Yes No BASIC PRINTER SKILLS * Yes No BASIC SIMPLE SWAP * Yes No CABLING * Yes No SCISSOR LIFT OPERATION * Yes No AV CABLES PULLING * Yes No AV CABLES QUOTES & ESTIMATES * Yes No AV CABLES TERMINATING * Yes No AV SURVEY & INVENTORY * Yes No INSTALL AV EQUIPMENT * Yes No ETHERNET PULLING * Yes No ETHERNET TERMINATING * Yes No ETHERNET QUOTES & ESTIMATES * Yes No ETHERNET SURVEY & INVENTORY * Yes No FIBER OPTIC PULLING * Yes No FIBER OPTIC TERMINATING * Yes No FIBER OPTIC QUOTES & ESTIMATES * Yes No FIBER OPTIC SURVEY & INVENTORY * Yes No RACK SERVER, REPAIR/INSTALL * Yes No ELECTRICAL LICENSE HIGH VOLTAGE, 110V/220V * Yes No CONCRETE DRILLING * Yes No CUSTOM FIXTURE FABRICATION * Yes No DRILLING WALLS, COUNTERS, SURFACES * Yes No MOUNTING AND REPAIRING DRYWALL * Yes No IBM MAINFRAMES (TERMINALS, PTR) * Yes No KIOSK EXPERIERCED * Yes No LAPTOP SKILLS * Yes No LINUX SKILLS * Yes No MCSE CERTIFIED CE * Yes No MULTI-FUNCTION PRINTER * Yes No MID-RANGE SYSTEMS * Yes No ADVANCED NETWORK SKILLS * Yes No NETWORK & SYSTEMS ENGINEER * Yes No PRINTER – HIGH SPEED * Yes No ADVANCED PLOTTER SKILLS * Yes No POINT OF SALE DEVICES * Yes No PROJECTORS * Yes No SCANNER, IMAGING UNITS * Yes No Large STK and IBM Silos * Yes No ADVANCED SERVER SKILLS * Yes No STORAGETEK REPAIR SKILLS * Yes No SUN MICROSYSTEMS DEVICES * Yes No TELEPHONY * Yes No UNIX OS SKILLS * Yes No UNINTERRUPTABLE POWER SUPPLIES * Yes No WAM WEIGHTS AND MEASURES CERTIFIED * Yes No * Yes No Certifications Attachments Corporate Overview/Resume * Drop a file here or click to upload Choose File Maximum file size: 67.11MB If you are human, leave this field blank. 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