19-16. NEW VENDOR FORM.docx
DOCX document 54 KB Posted
- Attached to
- Ancillary Employee Benefits
- Solicitation number
- 26004
- Issued by
- Maricopa County, Arizona
About this file
This is a New Vendor Form from Scottsdale Unified School District #48 Purchasing Department in Arizona for RFP #26004 regarding Ancillary Employee Benefits. The form serves as a vendor registration and acknowledgment document required for organizations seeking to provide products or services to the school district. The submission deadline is January 23, 2026. The form requests comprehensive vendor information including legal business name, contact details, payment information, and authorization to accept purchase orders. Vendors must provide a W-9 form along with the completed registration.
The form establishes critical operational requirements and compliance obligations for approved vendors. All vendors must comply with Arizona Revised Statutes Title 41, Chapter 9, Article 4, and Executive Order Number 75-5 regarding equal opportunity and non-discrimination requirements. Vendors are explicitly prohibited from providing any products or services without a valid, authorized SUSD Purchase Order and must direct all communications regarding purchase orders to the SUSD Procurement Office. The district requires vendors to include the purchase order number on all invoices submitted directly to SUSD Accounts Payable rather than requesting departments. The form also requires vendors to disclose any employment relationships with SUSD, family relationships with board members or employees, and to acknowledge that vendor registration does not constitute an obligation by the district to award a contract.
View the file
Other files
Show all 19
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Scottsdale Unified School District #48 New Vendor Form
Purchasing Department 9313 N. 95th Way Scottsdale, AZ 85258 480-484-6151
RFP #: 26004
PROJECT: ANCILLARY EMPLOYEE BENEFITS
| 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 |
| EMAIL ADDRESS FOR PURCHASE ORDERS (required) |
| EMAIL ADDRESS FOR ACCOUNTS RECEIVABLE (required) |
| WEB ADDRESS | |
| DOES YOUR COMPANY ACCEPT PURCHASE ORDERS? | |
| YES | NO |
UNIQUE ENTITY ID (formerly DUNS Number)
ARE YOU A SUSD EMPLOYEE?
YES NO IF YES, EXPLAIN:
LOCAL REPRESENTIVE NAME
RELATIVE OF SUSD EMPLOYEE?
| LOCAL REPRESENTATIVE CONTACT PHONE | ||
| YES | NO | IF YES, EXPLAIN: |
MEMBER OR RELATIVE OF SUSD GOVERNING BOARD?
LOCAL REPRESENTATIVE EMAIL
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 supplies information only and does not constitute an assumed obligation by Scottsdale Unified School District (SUSD) 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 SUSD 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 SUSD and that I will have to obtain payment from the individual requestor.
7. My organization will direct all communication regarding SUSD Purchase Orders to the SUSD Procurement Office.
8. My organization will provide the Purchase Order number on all invoices submitted to SUSD. I understand that invoices received without this information will not be paid.
9. My organization will submit all invoices directly to SUSD Accounts Payable and not to the requesting department or school.
| PRINTED OR TYPED NAME |
| TITLE |
| SIGNATURE |
| DATE |
Please Include a copy of your W-9 form.
RFP #: 26004 Page 1 of 1 Due: January 23, 2026 image1.png
File details come from the government source that posted it. Updated .