11-Vendor Registration Form.pdf
PDF 288 KB Posted
- Solicitation number
- 26-003-30
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Vendor Registration and Update Form issued by Creighton Elementary School District #14 in Phoenix, Arizona. The form serves as a prerequisite registration document for vendors seeking to conduct business with the district. Vendors must complete the form to provide organizational information, contact details for quotes and accounts payable, and declare whether they provide goods, services, or both. The district uses this registration to establish vendor eligibility for purchasing operations; however, registration does not guarantee contract awards or inclusion on the district's bid list. Vendors must obtain an authorized purchase order before providing any products or services and are prohibited from fulfilling requests based on verbal promises or requisitions alone.
The form requires vendors to acknowledge compliance with Arizona state statutes and federal equal opportunity and non-discrimination requirements under A.R.S. Title 41, Chapter 9, Article 4 and Executive Order 75-5. Vendors must declare any conflicts of interest, including whether they are current or related to CSD employees or governing board members. All invoices must reference the purchase order number and be submitted directly to CSD Accounts Payable rather than requesting departments. A completed W-9 form must accompany the vendor registration. Submissions should be directed to the CSD Procurement Office at rayers@creightonschools.org or mailed to Creighton School District #14 at 2702 E. Flower Street, Phoenix, AZ 85016.
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Text version
R e v 9 / 2 6 / 2 4
CREIGHTON ELEMENTARY SCHOOL DISTRICT #14
VENDOR REGISTRATION AND UPDATE FORM
ORDER INFORMATION PAYMENT INFORMATION
LEGAL NAME OF ORGANIZATION / INDIVIDUAL LEGAL NAME OF PAYEE
STREET ADDRESS STREET ADDRESS
STREET ADDRESS 2 STREET ADDRESS 2
CITY CITY
STATE ZIP STATE ZIP
PHONE NUMBER W/ EXTENSION FAX NUMBER PHONE NUMBER W/ EXTENSION FAX NUMBER
CONTACT NAME CONTACT NAME
CONTACT EMAIL FOR QUOTES EMAIL ADDRESS FOR ACCOUNTS RECEIVABLE
EMAIL ADDRESS FOR PURCHASE ORDERS DOES YOUR COMPANY ACCEPT PURCHASE ORDERS?
YES NO
WEB ADDRESS ARE YOU ON A COOPERATIVE CONTRACT?
DO YOU REMIT ARIZONA STATE SALES TAX?
YES NO
DOES YOUR COMPANY PROVIDE:
GOODS SERVICES BOTH
PLEASE DESCRIBE:
ARE YOU A CSD EMPLOYEE?
YES NO IF YES, EXPLAIN:
RELATIVE OF CSD EMPLOYEE?
YES NO IF YES, EXPLAIN:
MEMBER OR RELATIVE OF CSD GOVERNING BOARD?
YES NO IF YES, EXPLAIN:
VENDOR ACKNOWLEDGEMENTS - BY SIGNING BELOW, I HEREBY ACKNOWLEDGE THAT:
1. I am duly authorized to certify the information requested herein.
2. To the best of my knowledge, the elements of the information provided herein are accurate and true as of this date.
3. My organization will comply with all State statutes and Federal equal opportunity and non-discrimination requirements and conditions of employment in accordance with A.R.S. Title 41, Chapter 9, Article 4 and Executive Order Number 75-5 dated April 28, 1975.
4. Filing of a Vendor Registration Application provides information only and does not constitute an assumed obligation by Creighton Elementary School District
(CSD) to guarantee contractual awards or agreements to my organization.
5. Updating information contained on this form is solely the duty of my organization.
6. My organization will not provide any product or service without first having in our possession an authorized CSD Purchase Order. No products or services will be provided based on a verbal promise of a Purchase Order or with the submission of a requisition for a Purchase Order. I understand that payment for any product or service provided without an authorized Purchase Order is not the responsibility of CSD and that I will have to obtain payment from the individual requestor.
7. My organization will direct all communication regarding CSD Purchase Orders to the CSD Procurement Office.
8. My organization will provide the Purchase Order number on all invoices submitted to CSD. I understand that invoices received without this information will not be paid.
9. My organization will submit all invoices directly to CSD Accounts Payable and not to the requesting department or school.
10. This form allows CSD to issue Purchase Orders and payments. It does not provide inclusion in the Creighton Elementary School District Vendor’s Bid List.
PRINTED OR TYPED NAME TITLE
SIGNATURE DATE
**W-9 form must accompany this form** Please return form via Email to: rayers@creightonschools.org or mailed as follows:
Creighton School District #14, c/o Purchasing Dept., 2702 E. Flower St., Phoenix, AZ 85016 mailto:rayers@creightonschools.org
File details come from the government source that posted it. Updated .