File Upload "*" indicates required fields Your Name* First Last Your Email* Company Name* Company Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code About the AuditCertified Audit?*Is this audit for Publix Supermarkets, Fedex, Verizon or another company that requires certification? Select or enter the requesting company, or indicate that the audit is being conducted for internal purposes only. Verizon Publix Supermarkets Fedex Walmart No, this is an internal audit Other Primary ContractorIf your company is a sub-contractor on the contract, please provide the primary contractor’s company name. Contract NumberSome companies require that their contract number be shown on the certification. If you know the contract number, enter it here. You may need to contact the primary contractor for this information. Invoicing*We will send an invoice when the audit has been completed. Please indicate to whom the invoice should be sent. Send to me () Send to the Primary Contractor () Upload I-9 Files*Select up to 25 individual files. If we are reviewing identification documents, please include them in the same file as the form if possible. Drop files here or Select files Accepted file types: pdf, Max. file size: 30 MB, Max. files: 25. Certification TemplateIf the company requiring certification provided a template, you may upload it here. (Optional) Drop files here or Select files Accepted file types: pdf, Max. file size: 30 MB, Max. files: 3.
