Vendor Registration

Business Information

Legal Business Name *

DBA (Doing Business As)

Business Type *

EIN/Tax ID *

Business Address *

City *

State *

ZIP Code *

Office Phone *

Business Email *

Primary Contact Information

Contact Name *

Contact Phone *

Contact Email *

Create Password *

Service Capabilities

Service Types Offered *

Light Duty Towing Medium Duty Towing Heavy Duty Towing Winching/Recovery Roadside Assistance Impound Services

Average Response Time (minutes) *

24/7 Availability?

Service Areas (Enter ZIP codes)

Languages Spoken

English Spanish French Other

Fleet Information (Optional)

Number of Tow Trucks

Number of Drivers

Insurance & Compliance

Insurance Information

Please provide details for your current insurance policies. You'll upload certificates after approval.

General Liability Insurance *

Insurance Provider

Policy Number

Expiration Date

Coverage Amount

Commercial Auto Insurance *

Insurance Provider

Policy Number

Expiration Date

Garage Keepers Insurance?

Workers' Compensation Insurance

Compliance Affirmations

I affirm that the business owners have no felony convictions I affirm that we maintain a drug-free workplace I affirm that we have a clean DOT history and are in compliance with all DOT regulations I affirm that all vehicles pass regular safety inspections

Business Terms & Agreement

Accepted Payment Methods

ACH Transfer Check Wire Transfer

Preferred Payment Terms

Service Level Agreement

VERT Dispatch SLA Requirements:

Maximum 30-minute response time for standard calls
GPS tracking required on all vehicles
Professional appearance and conduct standards
Proper licensing and insurance maintained at all times
Timely communication with dispatch center

I agree to the VERT Dispatch Service Level Agreement

Vendor Agreement

Terms and Conditions:

Independent contractor relationship
Commission structure as per rate sheet
Insurance requirements must be maintained
30-day termination notice required
Dispute resolution through arbitration

I have read and agree to the Vendor Agreement Terms

Document Upload

Please upload the required documents below. Some documents are required for approval.

Digital Signature

Full Name (for signature) *

Title *

Vendor Partner Application