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Apple Gold Vendor Agreement Application — Company Information

Instructions: Please fill out all information. For questions please email

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Company Information
Vendor Name
Address 1 Address 2
City State

Areas/Restaurants Serviced  (You must select at least one location)

    North Carolina [view area map]
  • Central
  • Coastal
  • Eastern NC
  • North Charlotte
  • Raleigh
  • South Charlotte
  • Triad
  • z-Test Area
  • South Carolina [view area map]
  • Blake Pittman
  • Jim Broome
  • John Trone
  • Paul Boyd
  • Roger Blakley
  • SC Coastal
  • Oklahoma [view area map]
  • OK City
  • Tulsa
  • Arkansas [view area map]
  • Arkansas
  • Kentucky and Indiana [view area map]
  • Louisville


  Asphalt Paving   Beer Delivery Systems (Perlick)
  Carpet Installation   Carside Camera Systems
  CO2   Dishwasher
  Doors, Windows and Glass   Electrical
  Fire Protection - Sprinklers   Furniture - Barstools and Chairs
  Furniture - Booths   Gaskets - Refrigeration
  General Maintenance   HVAC
  Kitchen Equipment - Non-Refrigerated   Lighting Maintenance
  Locksmith   Microwaves
  Music System   Painting
  Plumbing   Plumbing - Parts
  Quarry Tile and Ceramic Tile   Refrigeration
  Roofing   Safes
  Security Camera Systems   Signage - Exterior and Building
  Stainless Steel Welding and Fabrication   Telephone Systems Hardware & Inside Wiring
  Vinyl Upholstery
Other     (List Service)

Contact Information
Do you currently do work for Apple Gold?
Company Owner:
Owner Phone #:
Service Request Contact Name:
Service Request Phone Number:
Service Request Email Address:
Company website:
After Hours Contact Name 1:
After Hours Phone Number 1:
After Hours Contact Name 2:
After Hours Phone Number 2:
Rate Information
Regular time rate $
Regular time hours of operation M-F From Until
Overtime rate $
Hourly billing increments
Cities/States Technicans are dispatched from
Trip charge (if any) $
Portal to portal
Vehicle charge (if any) $
Parts markup %
Subcontractor markup %
Early payment discount
Other charges or consideration (max 200 characters):
[E.g. Bucket Truck charge - $10.00]
List any disposal of material and associated rates (max 100 characters):

You have 100 characters remaining...
Payment Terms

Vendor invoices will only be processed when found to be in compliance with the agreed upon fees outlined above.  All invoices must contain all applicable City, County, Local or other Sales Taxes on each invoice submitted.  The Apple Gold Group (hereinafter “Apple Gold”) reserves the right to make any necessary sales tax adjustments.

Apple Gold payment terms are 30 days from the date of invoice receipt unless early payment discounts are offered.  Vendor expressly agrees to submit all invoices no later than 90 days after completion of all requested work.  Vendor expressly agrees that Apple Gold shall be relieved from any and all liability for any such invoices submitted after 90 days regardless of any state statute of limitations.

Name of person filling in form:

I have read and I agree to the above Payment Terms     
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