Vendor Verification & Registration

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Company Name(Required)

Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

HST(Required)

Insurance Certificate(Required)

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.

Insurance Expiry Date(Required)

WSIB Certificate(Required)

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 10 MB.

Business License(Required)

Accepted file types: png, jpg, jpeg, gif, pdf, Max. file size: 10 MB.

Billing Address(Required)

Street Address Address Line 2 City Province Postal Code

Annual Processing Fee(Required)

Price:

Total

Credit Card(Required)

Card Details

Cardholder Name