Create Vendor Account

Create Vendor Account

Vendor Credentials

Instructions

Complete the information, including choosing a login and password and payment information.
Agree to the terms and conditions. For more information on a specific data item, please click on the ? beside the item.
Click continue and if everything is correct you will be directed to the login page to begin your secure session. (You will be prompted for any incorrect or missing information.)
You will be sent a receipt for payment and account confirmation by email.
To view and manage your account, login to your account with your chosen login and password.
Submit Credentials
- Upload your own documents or scan
- Email your documents to credentials@vendorcredentials.com
- Fax your documents to 281-605-5541
Your documents will be verified within 72 hours and your status updated from pending to approved provided all paperwork meets standards.
Scan your valid driver's license at the facility, entry will be either permitted or denied depending upon your credential status.
Access to additional facilities will be provided at no charge, but an application request for each facility is required.
All vendors must complete the application process within 60 days of receipt of this document.

Login Information
Login:
Password:
Re-Enter:
Initial Facilty:
Level:
Company:
Company Website:
Manager:

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Vendor Information
First Name:
Last Name:
Contact Address:
City:
State:
Zip:
NOTE: Please enter your Drivers License number exactly as it appears on your actual ID, including spaces, dashes, etc.
Driver's License # :
DL State :
Phone:
Email:

Payment Information

Name on Card:

CVS:

Card Number:

Exp. Date :

/

Amount:

Same as Contact Address

Billing Address:

City:

State:

Zip:

Legal Agreement

This agreement ("Agreement") between the vendor executing below ("Vendor") and Vendor Credentials, LLC ("Company"), collectively the "Parties", was entered into on the date of acceptance.

Subject to the terms and conditions of this Agreement, Vendor wishes to register with Vendor Credentials, LLC vendor credentialing system and software for the purpose of allowing healthcare facilities to verify Vendor’s credentials.  COMPANY maintains a database of vendor credentials and provides hardware, software and access to said database to support healthcare facilities’ vendor credentialing process.  

Term - This agreement shall be effective as of the date of execution of this agreement (the "Effective Date") and shall have an initial term of one (1) year. This Agreement shall renew annually for successive one (1) year terms, unless either party provides written notice of its intention to terminate the contract at the completion of the current term not more than sixty (60) days and not less than thirty (30) days prior to the expiration of the current term.

Compensation - In return for the equipment, software and access to the database set forth above, Vendor agrees to pay the annual fees charged by Company for these services. 

No Employment - Nothing in the Agreement shall create an employer-employee relationship between the Parties and Vendor agrees not to represent himself or any of his employees, agents or representatives explicitly or implicitly as employees of Company.  

INDEMNIFICATION, LIMITED WARRANTY AND DISCLAIMER

VENDOR CREDENTIALS, LLC SOLELY WARRANTS AND GURANTIES THAT IT SHALL PROVIDE A REQUESTING FACILITY WITH EQUIPMENT AND ACCESS TO A DATABASE OF VENDOR CREDENTIAL INFORMATION.  VENDOR CREDENTIALS, LLC ACTS SOLELY AS A DATA CLEARING HOUSE TO ALLOW VENDORS AND FACILITIES A METHOD AND SYSTEM FOR PROVIDING AND VERIFYING VENDOR CREDENTIALS.  VENDOR CREDENTIALS, LLC MAKES NO REPRESENTATION AS TO THE  ACCURACY OF THE INFORMATION CONTAINED WITHIN THE DATABASE AND SPECIFICALLY, VENDOR CREDENTIALS, LLC ASSUMES NO LIABILITY FOR ACTS, OMISSIONS OR MISREPRESENTATIONS COMMITTED BY VENDORS PARTICIPATING IN THE VENDOR CREDENTIALING PROGRAM.

VENDOR, BY EXECUTING THIS AGREEMENT BELOW AFFIRMS THAT ALL INFORMATION SUBMITTED TO THE DATABASE ON HIS/HER BEHALF IS ACCURATE AND CORRECT AND VENDOR AGREES TO INDEMNIFY COMPANY FROM ANY CAUSE, CLAIM OR LIABILITY RESULTING FROM INACCURATE, INCOMPLETE OF FALSE INFORMATON CONTAINED IN SAID DATABASE.

Waiver - No waiver of any term or condition is valid unless it is in writing and signed by an officer of the party charged with the waiver.  No waiver of any specific obligation shall be construed as a waiver of any subsequent breach.

Confidentiality of Records - VENDOR acknowledge that in the performance of this Agreement, VENDOR shall provide COMPANY with confidential information and acknowledges that such information is to be maintained in a database that will be available to third parties for review.  COMPANY agrees that except to such intended third-parties, it will not disclose to any third party or utilize for their own purposes any proprietary or confidential information disclosed to them pursuant to the performance of services under this Agreement except as is required by a court of law.

Confidential and Proprietary information is defined as information, data, documentation, process, etc. developed, produced or purchased by either of the Parties that is not:

i.generally known to the public;
ii.separately and independently developed by the Parties;
iii.disclosed by a third party; and/or,
iv.disclosed to a third party by the disclosing Party.

Counterparts - This Agreement may be executed in one or more counterparts, each of which shall be deemed an original but all of which counterparts shall constitute collectively one instrument representing the Agreement among the Parties.

Binding Agreement - This Agreement shall be binding and inure to the benefit of the Parties, their heirs, executors, successors and assigns.

Headers - Descriptive headings are for convenience only and shall not control or affect the meaning of construction of any provision of this Agreement.

Severability - If any provision of this Agreement is held to be invalid, or unenforceable under present or future laws effective during the term of this Agreement, such provision shall be fully severable and this Agreement shall be construed and enforced as if such illegal, invalid or unenforceable provision was not a part of this Agreement and the remaining provisions shall remain in full force and effect and shall not be affected by the illegal, invalid or unenforceable provision. 

Assignability - This Agreement may not be assigned or transferred without the prior written consent of the Parties.

Mediation - The Parties agree that in the event that a dispute arises between the Parties as to the terms, rights or responsibilities under this Agreement, the Parties will submit the dispute to mediation before a mediator before resorting to litigation.  The mediator shall be chosen by the Parties and the costs of mediation shall be born equally.

Entire Agreement - The Parties acknowledge that this Agreement represents the entirety of the agreement between the Parties and that there are no other agreements written or spoken between the Parties.  Any amendment or alteration to the terms of this Agreement must be in writing and signed by both Parties, except where specifically recognized under the terms of this Agreement.

Governing Law - This Agreement shall be interpreted under, and construed in accordance with, the laws of the State of Texas and the parties hereby agree to jurisdiction in the courts of Harris County, Texas.

VENDOR agrees to be bound by the terms of this agreement effective on the date of execution by marking the box below.


	I agree to be bound by the terms of the Agreement set forth.