Vendor_Information_Form.docx

VENDOR INFORMATION FORM

FORM MUST BE RETURNED WITH QUOTE

QUOTED BY: ________________________________

DATE: _____________________

COMPANY NAME: ____________________________

EMAIL ADDRESS: ____________________________

PHONE: ___________________

SMALL BUSINESS?: Yes or No

FAX: ______________________

ADDRESS: __________________________________________

DUNS NO: ______________

CAGE CODE: ___________

SAM EXPIRATION DATE: _______________

All vendors doing business with the Government are required to be registered with the System for Award Management (SAM). NO award can be made unless the vendor is registered in SAM. For additional information and to register in SAM, please access the following website: www.sam.gov. In order to register with the SAM and to be eligible to receive an award, all offerors must also have a Dun & Bradstreet Number. A Dun & Bradstreet number may be acquired free of charge by contacting Dun & Bradstreet on-line at https://www.dnb.com/product/eupdate/requestOptions.html or by phone at (800) 333-0505.

This procurement also requires offerors to complete the electronic representations and certifications at the SAM website. All responsible and fully responsive sources may submit a proposal which will be considered by the Agency.