New Customer Questionnaire

Applying for Credit? Click here to submit a Credit Application

Company Name *

Tax ID/ FEIN

Billing Address Line 1 *

Shipping Address Line 1

Phone Number *

Same as Billing Address

PO Required?

Fax Number

Sales Tax Exempt

Attach Resale or Tax Exemption Certificate if applicable*

D&B Number

Email Invoices to: *

Accounts Payable Contact *

A/P Email *

A/P Phone Number *

Owner(s), Partner(s), or Corporate Officer(s) *

Submitted By *

Please attach F-W9 (2024 Rev.), Resale/ Tax Exemption Certificate (if applicable) and Certificate of Insurance (Subcontractors Only).

I Agree to the RumTec Solutions LLC Terms & Conditions *

By Submitting this Questionnaire, I hereby certify that:
-I am a director, officer, or partner.
-these statements are correct to the best of my knowledge.
-I agree to the RumTec Solutions Standard Terms and Conditions.

Submit