BIC Tenant Contact Information

First and last name of the person who will sign agreements.*

First Last

Email address for the person who will sign agreements.*

Official name of company:*

Corporation location:*

Year of incorporation:*

Official Company Address*

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

Point of contact and email address for the person to whom insurance certificate requests should be made:*

First Last

Email address for the person to whom insurance certificate requests should be made:*

Point of contact for billing (i.e. invoices will be sent to the attention of this person):*

First Last

Phone number for billing contact*

Email address for billing contact*

Full company address to which invoices should be sent:*

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