Check One:
 Proprietorship  Corporation      General Contractor
 Partnership     LLC

Check One:
 New Account  Revision

 Parent Company Name

 

Street Address


City


State

Business Name


Street Address


City


State


County


Zip

Phone


Fax

 

Email Address

 

Duns ID Number


Federal ID Number

 

Nature of Business


If Corporation, When and Where Incorporated


If Partnership, Date of Agreement


If Sole Ownership, Date of Ownership




PRINCIPAL OFFICERS OR ALL PARTNERS  

Chief Executive

 

Financial Executive

 

Accounts Payable

 

The undersigned hereby certifies that all information is true and correct. It is understood that Universal.biz's eBusiness contract partner, hereby offers to establish an ecommerce business relationship provided your company recognizes and agrees that its eBusiness concepts, programming, tools, and the application of such are made available only for material purchasing purposes and are the exclusive property of Universal.biz's eBusiness contract partner. Your company agrees to all of the above stipulations and agrees not to copy, duplicate by facsimile the site, or its structure, or open the site to unauthorized users. Use of the site constitutes the acceptance and your agreement to the site's terms.