Supplier request form Please fill in the form below to be added to our potential supplier list. Please note that unless otherwise stated, all fields are mandatory. Main Contact Information First Name: Last Name: Main Contact Phone Number: Format: +1 (555) 666-7777 Main Contact Email: Format: yourname@example.com Sales Information Name of VP Sales: (optional) VP Sales Phone: (optional) Format: +1 (555) 666-7777 VP Sales Email: (optional) Format: yourname@example.com Company information Company Name: Company Address: Country: - Select -CanadaUnited States of America Province / State: - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Province / State: - Select -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon City: Postal Code or Zip Code: Format: A1A 1A1 or 12345 Date of Incorporation: (optional) Date of Incorporation: (optional): Year Year1900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 Date of Incorporation: (optional): Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Date of Incorporation: (optional): Day Day12345678910111213141516171819202122232425262728293031 Number of Employees: (optional) Do you count the Public Works in the list of your clientele? Yes No In process Company Description and other comments: (optional) What are the Goods and/or Services you company generally supplies? (optional) Goods Car & Locomotive parts & Equipment: Bellringers, horns, chimes (2263) Cab & car interior (2471) Car body structure (2361) Car coverings & trims (2472) Car doors, steps, panels (2322) Diesel engines & mechanical parts (3029) Engines & power supplies (2529) Galley items (2441) Heater strips & elements (2659) Hoses and fittings (4247) Hvac and refrigeration (2641) Insulation tubing (4256) Motors, armatures, transducers (2559) Power distribution equipment (2561) Power transmission / Gears (3030) Rolling stock loco / Cars (5422) Sun visor, wipers, handle (2422) Toilet / Sink / Shower components (4245) Traction motor (0459) Trucks and wheels (2922) Chemical: Adhesives, fillers, thinner (4780) Chemicals & compressed gases (4768) Cleaners, soaps, deodorants (4879) Disinfectants & cleaners (4868) Energy and lubricant products (4691) Paints & varnishes (4880) Electrical & Electronic: Electrical products (2759) Electrical wire & cable (2761) Electronic products (2859) Lighting products (2762) Photographic equipment (6067) Televisions & radios (2877) Video cassette recorder (2858) Food & Beverage: Baked & cereal products (418920) Beverages - alcoholic (418965) Beverages - nonalcoholic (418960) Coffee, tea & cocoa (418955) Condiments & related products (418950) Dairy foods & eggs (418910) Food, oils and fats (418945) Fruits and vegetables whole (418915) Fruit & vegetable juices (418916) Jams, jellies & preserves (418930) Meat, poultry & fish (418905) Prepared foods (418940) Soups and bouillons (418935) Sugar, confectioneries, nuts (418925) Water bottled (4189) Hardware: Air bags (2026) Air component - toilet system (2245) Air system parts (2222) Bearings (1431) Dispensers, containers (2445) Fasteners (1153) Filter - engine (1229) Filter - miscellaneous (1222) Filter - pressure / Vacuum (1243) Filter - water (1246) Gaskets & seals (1353) Glass and windows (1793) Iron, steel forgings & iron (1922) Metal - cloth & mesh (2153) Metal - plates, bars, etc Metal - ropes, chains, etc Mirror (1771) Pin, sleeve, bushing, spring (1822) Rubber products (1393) Shop machinery (3134) Suspension & hydraulic (2022) Tape insulator / Electric (1159) Transmission chains (1430) V-belt (1330) Kitchen Accessories: Cutlery and flatware (417340) Kitchen equipment & appliances (417320) Kitchen hand tools, utensils (417330) Sets, kits & outfits (food preparation & serving) (417360) Tableware disposable (417351) Tableware re-usable (417350) Office: Book, magazine, periodical (5276) Computer equipment & supplies (6070) Office furniture (6071) Office machines & accessories (6074) Office supplies & accessories (5275) Paper & forms (527530) Rail Infrastructure: Ballast, rip-rap (0156) Communication devices (0258) Construction materials (0356) Flag kits (0183) Fuel plant (0949) Lumber and wood (0355) Prefabricated structure (0354) Signals (0163) Steam generating plants (0944) Storage tanks (0954) Track & switch materials (0122) Tools: Grease guns (4549) Hand tools - general (4551) Measuring tools & gauges (4452) Meters, detectors, recorder (4466) Welding tools & equipment (4534) Uniforms & Linens: Draperies, linen, carpets (6572) Leather, canvas, fabric (6583) Uniforms (6584) Vehicles: Automobiles & trucks (1023) Auto & truck spares (1025) Heavy vehicles (1038) Tractors (1024) Warehouse & Physical Plant: Cleaning equipment & supplies (4079) Elevators & escalators (3960) Fire fighting equipment (6242) Hoist, lifts, cranes (3139) Identification material (3699) Laundering / Sewing machine (3135) Material handling equipment (1039) Medical & first aid (6265) Paper products, garbage bags (4045) Protective wear / Equipment (6284) Pumps & compressors (3143) Rags (6579) Refractory clays (3293) Sand (1196) Shipping material (3681) Steam boilers (electric components) (3259) Steam boilers & related parts (3244) Water treatment plant (3146) Wrapping paper shipping (3693) Services Architech and Engineering Services: Architect & Engineering Services Related to Construction (90C001) Highways, Roads, Streets, Bridges and Railways (90C122) Other Architect & Engineering Services (90C219) Communications, Photo and Printing: Advertising services (90T003) Arts / Graphics services (90T005) Audio / Visual services (90T018) Communication studies (90T000) Market research and public opinion services (90T001) Print / Binding services (90T014) Public Relations Services (90T004) Reproduction services (90T015) Signs, advertising display & identification plates (9905) Construction and Maintenance: Construction work (5100) Maintenance, repair and modification (90J) Environmental Services: Haz. Substance Removal, Clean up, Disposal Svces & Oper. Supp. (90E108) Information Systems & Telecom: Network management services (90D316) Systems development services (90D302) Telecommunications and transmission services (90D304) Lease and Rental of Equipment: Lease and rental of equipment (90W) Monitoring, Custodial and Accommodation: Alarms (6263) Carpet cleaning (90K111) Fire protection services (90K101) Fueling and petroleum services (90K103) Guard services (90K105) Hotel accommodation (90K198) Insect and rodent control (90K106) Interior plantscaping (90K112) Janitorial services (90K100) Landscaping and groundskeeping (90K107) Laundry and dry cleaning (90K108) Other custodial and related services (90K199) Other salvage services (90K116) Parking (90K197) Preparation and disposal (excess & surplus prop Snow removal / Salt services (90K113) Solid fuel handling services (90K110) Surveillance services (90K109) Trash and garbage collection (90K104) Waste treatment and storage (90K114) Professional and Admin: Architect and engineering services (90C) Courier and messenger services (90R103) Educational and training services (90U) Environmental services (90E) Financial and related services (90L) Health and social services (90G) Industrial hygenists (90R119) Mailing and distribution svces (excl Paper shredding services (90R117) Quality control, testing and inspection (90H) Real estate brokerage services (90R118) Studies and analysis (90B) Translation and interpreting services (90R109) Transport, Travel, Relocation: Motor freight (90V001) Relocation services (90V502) Security vehicle services (90V011) Taxicab services (90V010) Travel Agencies (90V503) Warehousing and storage services (90V505) Utilities: Utilities (90S) This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. 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