New_Vendor_Form.doc
DOC document 23 KB Posted
- Attached to
- Fitness Center Equipment Rental
- Solicitation number
- 03252015_Fitness_Center_Equipment_Rental
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New Vendor Form
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Other files
| File | Type | Posted |
|---|---|---|
| Purchase_Agreement--Master_Form_Template_(Rev_9-2014)-.docx | DOCX document | |
| Tax_Exempt_Certificate.pdf |
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Text version
Alutiiq, LLC – WESTOVER JOB CORPS Vendor/Company Name
Contact Name
Mailing Address
Phone #_______________________________
Fax #_________________________________
E-Mail________________________________
Vendor Categories (check all that apply):
_____Small Business
_____Small Disadvantaged Business
_____Women-Owned Small Business
_____Veteran-Owned Small Business
_____Service-Disabled Veteran-Owned Business
_____HUB Zone Small Business
_____Large Business
_____Government
_____Non-Profit
Under Section 16 of the Small Business Act and Title 13 of the Code of Federal Regulations, any person or concern that knowingly misrepresents the small business size status of a person or concern in connection with federal government subcontracting opportunities is subject to penalties, including fines, imprisonment, and debarment.
I certify that I have checked the appropriate categories for myself or my company. Any Small Business categories selected meet the attached “Definitions for Small Business Categories”.
Signature of Company Representative
Date
Printed Name
Title
File details come from the government source that posted it. Updated .