Epic Group Vendors

The Epic Group LLC
30778 Wealth Street
Murrieta CA 92563
(800) 506-8760
[email protected]

Vendor Agreement

"*" indicates required fields

1. Vendor Information

Business Name* Tax Identification Number (TIN)*

Address*

Street Address

Address Line 2

City

State

ZIP Code

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2. Payment Terms

Preferred Payment Method* Payment Terms* Bank Name (if applicable)Routing Number Account Number

3. Contact Information

Primary Contact Name* Phone*Email*

4. Services Provided

Service(s) Provided*

5. Authorization

Authorization*

I, the undersigned, certify that the information provided above is accurate and complete to the best of my knowledge. I agree to the payment terms stated above and confirm that I am authorized to represent the vendor.