Supplier Qualifications
What We Buy
Animal Welfare
Tell Us About Your
Company
Brinker Supplier Partner Support
Supplier Diversity
Supplier Profile Form
*
= required field
Date:
*
Legal Company Name:
*
Doing Business As:
Physical Address:
*
City:
*
State:
*
Zip Code:
*
Mailing Address:
Address Line 2:
Company Phone Number:
*
Company Website Address:
(ex. www.examplesite.com)
Number of Employees:
Annual Sales Volume:
Years in Business:
*
Describe Type of Business:
*
---Choose Type of Business---
Audio Visual Equipment
Cooking Equipment
Décor
Disposable Packaging and Utensils
Equipment Installation Services
Exterior Signage
Facilities/R & M Contractor
Furniture
General Contractor/Remodel Contractor
Information Technology and Hardware
Office Equipment and Services
Print Materials
Restaurant Equipment and Installation Services
Refrigeration
Smallwares
Uniforms and Promotional Products
Other
List Any Restaurant Customers:
*
Service Area (select)
(specify)
Local
Regional
National
International
Primary Contact:
*
Title:
*
Email Address:
*
Phone Number:
*
Are you a certified minority, woman, veteran, disabled veteran or LGBT-owned company?:
*
Yes
No
Certifying Agency or Entity:
Certification Number:
Expiration Date:
(ex. 01/01/12)
Principal Owners Name:
Title:
Gender:
Male
Female
Ethnicity: (select)
African-American
Asian-Indian American
Asian-Pacific American
Hispanic American
Native American
% Ownership
Additional Comments:
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