New Vendor Information

When you have completed your W9 and the Solutions Pinnacol Assurance paperwork, please fill out this form to upload those documents and send us your banking information. Please note all data transmitted in this form is encrypted and permanently deleted after confirmation with our Finance team.

1. Download and fill out the W9 and Pinnacol Assurance documents.

Download W9 PDF Pinnacol Assurance PDF

2. Fill out the form and upload the W9 and Pinnacol Assurance Documents.

Name(Required)

First Last

Email Address(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number(Required)

Preferred Payment Method

BANKING INFORMATION

Name of Bank

Bank Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Account Type

Account Number

ABA/Routing Number

SWIFT

IBAN

Check Mailing Address

Is your check mailing address the same as above?

Check Mailing Address

Street Address Address Line 2 City State ZIP Code

DOCUMENT UPLOAD

Please upload your W9 form here.

Max. file size: 800 MB.

Upload 1 supported file: PDF, document, or image. Max 100 MB.

Please upload your Solutions Pinnacol Assurance form here.

Max. file size: 800 MB.

Upload 1 supported file: PDF, document, or image. Max 100 MB.

New Vendor Information

1. Download and fill out the W9 and Pinnacol Assurance documents.

2. Fill out the form and upload the W9 and Pinnacol Assurance Documents.

BANKING INFORMATION

Check Mailing Address

DOCUMENT UPLOAD

General Inquiries: 1-800-290-0311

Finance Department: 720-722-7339