Business Partner

Please download the W9 and Supplier Certification PDF forms by clicking the buttons below.

Company Information
Thank you for being a valued Shimmick business partner. Please complete the information below.
New/Existing*
- Existing Partner
- New Partner
Legal Name*

(As listed on W-9)
DBA Name:*

(If different from Legal Name)
Address*
Street: Suite: City: State: ZIP/Postal: Country:
Phone:*
Website
Legal Entity Type:*
FEIN:*
Is your company a small, disadvantaged, woman-owned, or veteran-owned business?
- No
- Yes
Upload Completed Supplier Certification Form:*
Max. file size: 128 MB.
Payment Address (if different from above)
Payment Address:
Street: Suite: City: State: ZIP/Postal: Country:
Payment Contact
Name:*
Phone:*
Email:*
License Information
Applicable State:
License Number:
Registration Number:
Additional Information:
Upload W-9 Attachment (pdf):*
Max. file size: 128 MB.
EFT Information
Will you be providing EFT Information?*
- Yes
- No
Email:*

(For EFT remittance)
Routing Number:*
Account Number:*
Upload Voided Check or Letter from Bank*
Max. file size: 128 MB.
Completed By:*

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