![]() |
![]() |
||
|
|
| Purchasing Section
|
Vendor Registration Application Finance and Management Agency |
|
1. Company Name and Address For Receiving Bids and Purchase Orders: If address is correct, please check ( ) box. |
| If the above address is NOT correct, please print any changes or corrections in the space below. |
|
|
Company Name: |
|
Address: |
|
City: |
|
State: |
|
Zip Code: |
|
(Must Provide Zip, Plus Four) |
2. Vendor Contact Information: |
Please print only one department/individual to contact regarding Bids/Purchase Orders |
Contact Person/Department: |
|
Telephone No: |
|
Fax No: |
|
Email: |
|
Federal Employer ID Number
|
or |
Social Security Number |
4. Organization Type (Check Only One): |
Individual ______(I) |
Partnership ______(P) |
Non-Profit ______(N) |
Corporation ______(C) |
Joint-Venture ______(J) |
Other ______(O) |
| |
![]() |