Handicap Ramps and Wheelchair Ramps

Business information

Your name*

Are you the business owner?*

Yes
No

Who is the business owner?*

Legal business name*

Are you doing business as this name?

Yes
No, I'm doing business as another name

What name are you doing business as?

Which of the following are you operating as?

Partnership
LLC
Corporation

Date business started*

Veteran owned status*

VOSB
SDVOSB
None

Which of the following describes your business?*

Please check all that apply.

Franchise
Dealer
Independent
Accessories
Repair
Other

Which types of ramps does your business sell or service?*

Please check all that apply.

Residential ramps
Commercial ramps
Portable ramps
ATV/Recreational ramps
None of the above

Does your business sell and/or service any other brands?

If so, please list them below.

Business billing address*

Business shipping address*

Same as billing address

What type of property is this?*

Residential
Commercial

Is there a liftgate?

Yes
No

Contact information

Phone*

Fax

Email*

Website

Billing information

Accounting email

Purchasing email

Federal ID #

Resale tax #

Business references

Business reference 1 of 3

Business name*

Account #

Contact name*

Phone*

Fax

Email

Business reference 2 of 3

Business name*

Account #

Contact name*

Phone*

Fax

Email

Business reference 3 of 3

Business name*

Account #

Contact name*

Phone*

Fax

Email

Document uploads

Please upload the following documents:

Completed Michigan Sales Tax Exempt Form
General Liability Insurance

Upload files here*

Drop files here or

Max. file size: 128 MB.

General consent*

By submitting this form, you confirm that all information presented above is true and accurate to the best of your knowledge.*

Consent*

You are the business owner, partner, or corporate officer.*

Comments

This field is for validation purposes and should be left unchanged.