Vendor Qualification Vendor Qualification Form Please Fill Form Given Below For Vendor Qualification. QUESTIONAIRE COMPLETED BY:Company*Name*TitlePhone*Date Completed MM slash DD slash YYYY SUPPLIER INFORMATION:Full Legal Name*Type of Entity*State of Formation*State of Formation*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWebsite AddressSUPPLIER ADDRESS:Address for Contractual Purposes:Street Address*City*State*Zip Code*PAYMENT ADDRESS:Address*City*State*Zip Code*SUPPLIER POINT OF CONTACTContact NameContact TitleContact Email Contact PhoneAFFILIATES:Please provide a list of all supplier affiliates that you have a current contract with Transglobal Services, LLC and/or any of its domestic affiliates. AffiliatesDESCRIPTION OF THE WORK:Provide a description of the types of goods, services, and/or equipment rentals requested by Transglobal and/or its affiliates. Type of work provided? Goods Services Equipment Rentals DescriptionWhere Will the Supplier Work?Where Will the Supplier Work?AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWill supplier personnel be performing work at a Transglobal worksite (and/or a Transglobal affiliate worksite?)Will supplier personnel be performing work at a Transglobal worksite (and/or a Transglobal affiliate worksite?) Yes No ISNetworld MEMBERSHIP:If performing work at a Transglobal and/or Transglobal affiliate worksite, or as otherwise required, supplier must be a member of ISNetworld (ISN). If supplier does not have an ISNetworld subscription, please contact ISN at (214) 303-4900 to register. All ISN subscribers pay an annual fee plus a one-time account set-up fee, which is Supplier’s responsibility.Is supplier a current ISNetworld member? Yes No ISN NumberName of ISN Registered CompanyIf no, is supplier included under another affiliated ISN account? Yes No NamePlease provide supplier's contact person for ISN issues:Email PhoneCONFLICT OF INTERESTSDoes Supplier’s staff have any relatives working at Transglobal or does anyone working at Transglobal have any financial or ownership interest in supplier (excluding ownership in supplier’s securities if supplier is publicly traded)?Working at Transglobal Yes No CAPTCHA