Procurement Supplier Application

People sitting at a table with papers and tablets on the table.

Thank you for your interest in becoming a Bailiwick® Procurement Supplier Partner. We believe the best way to begin a potential partnership is to learn as much as we can about your business and your capabilities.

We review applications monthly for areas of need and overall potential fit based on responses provided in the application. As a result, not all applications will receive a response.

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Company Name

Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Business Contact Name

First

Last

Business Contact Phone Number

Business Contact Email Address

Website / URL

Select if Billing address is different from corporate address

Billing address is different

What are your payment terms

In net days.

Other Locations / Main Distribution Centers

Please provide an overview of your organization and its history.

Attach a product line card.

Click or drag a file to this area to upload.

At the time of onboarding, Bailiwick requires our Vendors be on direct deposit for payments. Is your company willing to do a direct deposit?

Yes, we will use direct deposit.

List all relevant Manufacturer Partnerships in place for cabling, connectivity, equipment, etc.

List any additional services your company provides (i.e. consolidation, config, warehousing of customer owned products, etc.)?

Is your company a certified MBE, DBE, WBE, TG/ED/VO (i.e. minority, women, veteran owned) business?

Does your company have a Green/Recycling Program in place?

How did you hear about us?

COI Insurance Requirements

The following minimum insurance requirements are required of all Supplier partners.

General Liability ($1,000,000 each: General Aggregate, Personal Injury, Completed Work & Products, & Per Occurrence coverage)
Auto Insurance ($1,000,000 coverage)
Workers Comp / Clearance Insurance ($100,000 – $500,000 – $100,000 coverage)

Checkboxes

By checking this box, you agree to meet the insurance requirements.

Unleash the Power of Curiosity and Innovative Problem-Solving!

Connect with us today, and let’s explore the unique ways we can propel your business forward.

Your success is our passion – let’s make it happen together!