11-Vendor Information Form - 2024.pdf
PDF 119 KB Posted
- Solicitation number
- BC-BID-26-24
- Issued by
- Bergen County, New Jersey
About this file
This is a Vendor Information Form from the County of Bergen Department of Administration and Finance, Division of the Treasurer, for vendors seeking to participate in the Food and Beverage Concession opportunity at Bergen County Department of Parks' three golf course locations. The concession operation encompasses Overpeck Golf Course, Rockleigh Golf Course, and Darlington Golf Course. Qualified concessionaires may bid on one, two, or all three golf course locations. The Overpeck Golf Course Concession operation will be awarded for an initial three-year term with two optional one-year renewal periods. The Rockleigh and Darlington Golf Course Concession operations will be awarded for three consecutive seasons with two optional seasonal renewal periods.
The Vendor Information Form requires submission of company details including legal business name, address, authorized official contact information, IRS business classification, and tax identification information. Vendors must provide remittance address and payment details if different from the primary vendor address. The form requests specification of business classification type, including options for small business status, minority ownership, women ownership, and veteran ownership designations. All vendors submitting this form must certify the accuracy of the information provided. Submission of this form is a required component of the bidding process for any qualified concessionaire interested in operating food and beverage services at one or more of the three designated Bergen County golf course facilities.
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Text version
COUNTY OF BERGEN
DEPARTMENT OF ADMINISTRATION AND FINANCE
DIVISION OF THE TREASURER
One Bergen County Plaza• Suite 501 • Hackensack, N.J. 07601-7076
(201) 336-6550 • (201 336-6595 James J. Tedesco, Ill County Executive
Jon Rheinhardt
CFO
Melissa Howard Treasurer
* - Required field
VENDOR INFORMATION FORM
Vendor Information (as displayed on W-9 form):
Company Name*:
Address*:
City*:
State*:
Zip Code*:
Name of Authorized Official*:
Phone Number*:
Email Address*:
Would you prefer that PO's to be emailed to the email address provided?
□Yes □No
Remittance Address: (if different than information above)
Pay-To-Name:
Pay-To-Address:
Pay-To-City:
Pay-To-State:
Pay-To-Zip:
Pay-to Attn:
Payment Email:
Business Classification:
Is your company a: * IRS Classification: *
□ Small Business □ Individual/ Sole proprietor
□ Minority Owned □ C-Corp
□ Women Owned □ S-Corp
□ Veteran Owned □ Partnership
□ Other: □ Trust/Estate
□ Not Applicable □ Limited Liability Corp - Corporation
□ Limited Liability Corp - S
Corporation
□ Limited Liability Corp - Partnership
□ Tax-Exempt Organization
I certify that the information provided on this form is true and accurate to the best of my knowledge.
Print Name: Signature:
File details come from the government source that posted it. Updated .