New Employee Offer Request

Your Name: *

Primary Vendor Contact *

Cost

Dealership Name *

Do we have a current Certificate of Insurance on File?

Payment Method *

Billing Frequency *

Vendor Portal Password

Contact Email *

Type of Vendor Arrangement *

Products or Services Provided *

Vendor Name: *

Contract Expiration or Renewal Date

Please compete this form as instructed! Thank you for your help!

Vendor Portal User Name

Does the Vendor have a Web Portal? *

Type of Submission *

Vendor Portal Website

Please Enter Additional Information Here

Maverick Motor Group

Vendor Management Form

Contact Phone Number

Do we have a current 2026 W9 on File? *