26W-1204_Contact_information_for_Firm.pdf

Supporting Contract Documents Firm Information, Order Processing, Individual Contact, and Customer Support Information

RFP 26W-1204

1. Contact information for firm’s headquarters:

Physical Address

Mail Address, if different

Main Phone Number

Website

2. Contact information for firm’s Arizona branch office:

Physical Address

Mail Address, if different

Main Phone Number

Website, if different

Add additional contact information if firm has more than one Arizona branch office.

3. Payment remittance address

Attn:

City State Zip

Telephone (invoice questions)

4. Provide Arizona Transaction Privilege (sales) Tax License Number:

Do you collect city, county, and/or other local sales tax in Arizona? Yes No

If yes, please check one:

Our combined state, city, county, and/or other local sales tax rate is % (local rate).

The sales tax rate varies by the location (e.g., ship to rate). Provide additional information below:

Supporting Contract Documents Firm Information, Order Processing, Individual Contact, and Customer Support Information

RFP 26W-1204

5. Contacts for Mohave:

Main Contract Vendor representative contact:

(Shall be the main point of contact for members and be responsible for member information requests.)

Title Email address

Phone number Fax

Contract Administrator contact:

(Shall be the main point of contact for contract information requests.)

Accounting contact:

(Shall be the main point of contact for accounting issues.)

Escalation contact:

(Shall be the main point of contact when an issue needs to be escalated above the main contact and/or contract administrator for the RFP/contract. This contact shall be a different individual than those named for the contacts listed above and who is authorized to make decisions for the firm.)

Audit contact:

(Shall be the main point of contact for audit requests and clarifications.)