Suppliers

To become an Axsun supplier, please, fill in and return this form along with the following documents:

• Certificate of Insurance. NOTE: Certificates must be submitted from your insurer or agent, showing Axsun Inc./Axsun Corp. as certificate holder

Send an electronic copy to: suppliers@axsungroup.com or by fax to 450-445-3427.

 

• Provincial, State or Federal authority (Please attach documents in PDF format below)

 

 

Supplier Information

 

Business Name:

Street Address:

City:

State/Prov:

Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon

Zip/Postal:

Primary Contact Name:

Phone Number:

Fax Number:

e-Mail Address:

Website:

Years In Business:

C-TPAT Certified?

Yes   No

SVI Number:

Geographic Area Served By Company:

Equipment Type(s):

Services Offered:

• Intermodal
• Highway
• Logistics
• Drayage
• Warehousing
• RFP Management

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