Become An Installer / Service Center

Mohawk Lifts, LLC. is committed to providing minority, women, veteran-owned and small businesses with an opportunity to participate in our procurement processes.

In order to achieve our goal to ensure that Mohawk Lifts, LLC has the most up-to-date business information, we are requesting our current suppliers download and complete the following forms below and submit them with the form below.

Required forms that need to be completed are available here:

• Business Profile Form
• W-9 Federal Taxpayer ID and Certification
• Certificate of Insurance Sample Form

"*" indicates required fields

Vendor Information

First Name*

Last Name*

Email*

Phone*

Company Name*

Address*

City*

State*

SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific

Zip Code*

Do want to submit a different shipping address?

Yes

No

Shipping Address

Shipping City

Shipping State

SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific

Shipping Zip Code

Do want to submit a different billing address?

Yes

No

Billing Address

Billing City

Billing State

SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific

Billing Zip Code

Business Profile Form

Click here to download the Business Profile Form

Please attach the completed business profile form.*

Max. file size: 50 MB.

W-9 Form

Click here to download the W-9 Form

Please attach the completed W-9 taxpayer form.*

Max. file size: 50 MB.

Certificate of Insurance Form

Click here to download the Certificate of Insurance Sample Form

Mohawk Lifts, LLC. is requesting a Certificate of Insurance from your company.

***Please request a certificate from your insurance agent naming Mohawk Lifts, LLC. as certificate holder and additional insured.***

Please make sure your insurance covers the following and meets the minimum requirements. Please also indicate policy expiration dates.

Minimum acceptable limits are: $1,000,000 general liability, $1,000,000 umbrella, $1,000,000 Auto Liability, proof of workman’s compensation.

Policy Expiration Dates:

General Liability*

MM slash DD slash YYYY

Umbrella*

MM slash DD slash YYYY

Automotive*

MM slash DD slash YYYY

Workers Comp*

MM slash DD slash YYYY

COI Confirmation*

Mohawk Lifts, LLC. is listed as certificate holder and additional insured.

Yes

Please attach the completed certificate of insurance form naming Mohawk Lifts, LLC. as certificate holder and additional insured..*

Max. file size: 50 MB.

Confirmation

Terms and Agreement*

I, the undersigned, have read and agree to the Mohawk General Terms and Conditions - Lift Installation.

Yes

First Name*

Last Name*

Date*

MM slash DD slash YYYY

Signature

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Contact Source

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