New Vendor Registration

Thank you for partnering with Rebellion Energy Solutions.

Who is Rebellion?

We are solving the century-old problem of unplugged orphan oil and gas wells by plugging wells and restoring the land, and as a result, creating high-quality, durable and meaningful carbon credits to our partners.

Our commitment to impact, transparency, and accountability extends to the results we deliver for the generations to come.

Our Partnerships

We hold all of our partnerships to the highest esteem and are grateful for the opportunity to work alongside a robust coalition of partners that make carrying out effective solutions out effective solutions to the complex legacy well challenge achievable.

Step 1 of 2

Hidden

Next Steps: Install a Payment Add-On

To accept payments on this form you will need to install one of our payment add-ons. To learn more about your payment add-on options, visit the following page (https://www.gravityforms.com/blog/payment-add-ons). Important: Delete this tip before you publish the form.

New Vendor Form

Company(Required)

Company Website

Company Information(Required)

TAX ID (please enter TAX ID number)

Corporation, governmental agency or tax-exempt

Only seeking reimbursement of expenses

Please check one.

TAX ID

XX-XXXXXXX

Primary Contact(Required)

First Last

Email(Required)

Enter Email Confirm Email

Primary Phone(Required)

Mobile

Address(Required)

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

Forms Needed

Please note that all field invoices need to be signed by an authorized Rebellion Energy Solutions, LLC representative.

Upload your signed W9(Required)

Drop files here or

Max. file size: 50 MB.

Upload your Proof of Insurance(Required)

Drop files here or

Max. file size: 50 MB.

Upload your State and/or Federal License/Evidence of Bond - if applicable

Drop files here or

Max. file size: 50 MB.

Upload Certificate of Good Standing with Secretary of State(Required)

Drop files here or

Max. file size: 50 MB.

The Rebellion Solution

Our difference is in our name

We are solving the century-old problem of unplugged orphan oil and gas wells by plugging wells and restoring the land, and as a result, creating high-quality, durable and meaningful carbon credits to our partners.

Our commitment to impact, transparency, and accountability extends to the results we deliver for the generations to come.

Learn about Rebellion Energy

Mission

Bringing energy, environment, and markets together to drive responsible completion of the oil and gas well lifecycle.

Vision

Include social and environmental value in the energy equation.

Rebellion Energy Solutions is a woman-led business with a multi-talented team of experts committed to creating sustainable solutions through oilfield cleanup and environmental justice in a comprehensive effort to restore the land, reduce harmful carbon emissions, and create taxable revenue streams for communities.

Rebellion Energy Solutions is headquartered in Tulsa, Oklahoma.

Quicklinks

Navigation

Our Mission

Bringing energy, environment, and markets together to drive responsible completion of the oil and gas well lifecycle.

Our Values

We are rebellious individuals, authentic communicators, unlimited collaborators, and creative thinkers. This is how we reach genuine solutions.

Our Vision

Include social and environmental value in the energy equation.

Our Partners

We hold all of our partnerships to the highest esteem and are grateful for the opportunity to work alongside a robust coalition of partners that make carrying out effective solutions to the complex legacy well challenge achievable.