Vendor Data Entry Form

Vendor Portal

Are you a new or existing vendor?*

New Vendor Existing Vendor

Company Name*

Name as it appears on checks and correspondence.

Vendor Data Entry Form

Please submit this form to add your company to our vendor lists.

TIP: Scroll to the bottom to save your progress and resume later.

Please submit this form to update your company's information on our vendor lists.

TIP: Scroll to the bottom to save your progress and resume later.

Which of our companies are you doing business with?*

Turco Golf Inc. Grasskeepers Landscaping Inc. Architects Golf Club Empire Development LLC 430 Montclair Ave LLC

Company Name*

Name as you would like it to appear on checks and correspondence.

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Primary Phone*

Primary Fax

Trade*

What is your trade?*

What is your trade? - Copy*

Business Enterprise Type

MBE SBE VBE DBE WBE Not Applicable

Vendor Receives a 1099?*

Yes No

Federal Tax ID*

Company Contacts

Select Contacts*

Primary Accounts Payable Accounts Receivable Billing

Other:

Primary Contact

Name*

First Name

Last Name

Job Title*

Email*

Primary Phone*

Alternate Phone

Accounts Payable Contact

Name*

First Name

Last Name

Job Title*

Email*

Primary Phone*

Alternate Phone

Estimating Contact

Name*

First Name

Last Name

Job Title*

Email*

Primary Phone*

Alternate Phone

Accounts Receivable Contact

Name*

First Name

Last Name

Job Title*

Email*

Primary Phone*

Alternate Phone

Billing Contact

Name*

First Name

Last Name

Job Title*

Email*

Primary Phone*

Alternate Phone

Other Contact

Name*

First Name

Last Name

Job Title*

Email*

Primary Phone*

Alternate Phone

Hold Harmless Agreement

Hold Harmless Terms

I have read, understand, and agree to the Hold Harmless Terms*

Yes, I Agree

Insurance

Policy Type*

General Liability Worker's Compensation Umbrella Automobile None

All Subcontractors MUST submit proof of coverage for General Liability & Worker's Compensation.

A SAMPLE COI IS PROVIDED BELOW. PLEASE MAKE SURE YOUR INSURANCE COMPANY IS PROVIDED THIS SAMPLE SO THEY FILL IT OUT CORRECTLY.

SAMPLE CERTIFICATE OF INSURANCE(PDF)

HOLD HARMLESS AGREEMENT (PDF)

Insurance Requirements*


Contract and Insurance Requirements 

As a subcontractor providing services to Stryker Golf LLC dba Architects Golf Club, we require that you provide us with the following as outlined below prior to the commencement of any work: 

Execute Hold Harmless Agreement
Certificate of Insurance with the minimum requirements outlined below. 

The owner of the Property must  also have a separate certificate with the same requirements.

Any subcontractor hired by you must also meet these requirements. 

Commercial General Liability (Occurrence Form) 
General Aggregate (other than Prod/Comp Ops Liability) 		$2,000,000 
Products/Completed Operations Aggregate 				$2,000,000 
Personal & Advertising Injury Liability 				$1,000,000 
Each Occurrence 							$1,000,000 
Fire Damage (Any one fire) 						$300,000 
Medical Expenses (Any one person) 					$5,000 

Stryker Golf LLC dba Architects Golf Club must be named as Additional Insured.

Lawrence P Turco and Dennis Turco must be named as Additional Insured.

Additional Insured Status must be on a primary and non-contributory basis.

The General Aggregate must apply on a per project basis and per location basis.

Broad Form Blanket Contractual Liability for liability assumed under the executed contract attached. 

Waiver of Subrogation in favor of Stryker Golf LLC dba Architects Golf Club Form # CG2404 or equivalent.

No New York State Labor Law or Third Party Action Over Exclusions.

30 Day Notice of Cancellation must be scheduled for Stryker Golf LLC dba Architects Golf Club.

Auto Liability 
Commercial Auto Liability Insurance covering the use of all Owned, Non Owned, and Hired Vehicles with combined Bodily Injury and Property Damage Limit of at least $1,000,000. 

No fault liability as required by statute.
Stryker Golf LLC dba Architects Golf Club must be named as Additional Insured.

Additional Insured Status must be on a primary and non-contributory basis.
Waiver of Subrogation in favor of Insured Form SAMPLE 2.

30 Day Notice of Cancellation must be scheduled for Stryker Golf LLC dba Architects Golf Club.


Workers Compensation and Employer’s Liability

Workers’ Compensation 						$1,000,000 Limits 

Employer’s Liability 
Bodily Injury by Accident 						$1,000,000 each accident 

Bodily Injury by Disease 					$1,000,000 policy limit 

Bodily Injury by Disease 					$1,000,000 each employee 

All States Endorsement

Umbrella Liability
Each Occurrence and Aggregate 					$5,000,000 

** The Umbrella must be excess over the General Liability, Automobile and Employers Liability.

Cyber Liability 
Per Claim Limit 							$1,000,000 

**Any coverage on a Claims Made form shall be maintained in force at all times during the term of the Contract and for a period of no less than two years thereafter for services completed during the term of the Contract.

The above coverage’s must be placed with an insurance company with an A.M. Best rating of A-:VII or better. 

Stryker Golf LLC dba Architects Golf Club reserves the right to require higher limits and/or additional coverage for specific exposures. 


Please upload your certificate in PDF format on this form.

General Liability Policy

Insurance Company*

Policy Number*

Effective Date*

Expiration Date*

Limit* $

Worker's Compensation Policy

Insurance Company*

Policy Number*

Effective Date*

Expiration Date*

Limit* $

Umbrella Policy

Insurance Company*

Policy Number*

Effective Date*

Expiration Date*

Limit* $

Automobile Policy

Insurance Company*

Policy Number*

Effective Date*

Expiration Date*

Limit* $

Upload Documents

Please upload all relevant documents.

All Subcontractors are required to upload a Certificate of Insurance, Contractor's License and W-9.

Click here to download a blank W-9 form from the IRS.

Certificate of Insurance

No File Chosen