4-Contractor Info Form.pdf
PDF 285 KB Posted
- Attached to
- Automated External Defibrillators (AED)
- Solicitation number
- ITB No. 2026-007
- Issued by
- Palm Beach County, Florida
About this file
This document is a blank Contact Information Form from the Town of Palm Beach Purchasing Division, located at 951 Okeechobee Rd., West Palm Beach, FL 33401. The form is designed to collect comprehensive vendor contact details across four distinct sections: Company Information, Contact Information, Purchase Orders, and Accounts Receivable. While no specific contract or procurement details are completed, the form provides a structured template for vendors to submit their organizational and communication particulars.
The form requires detailed information including company name, physical and mailing addresses, owner names, primary and alternate contact details, emergency contact information, purchase order contact, and accounts receivable contact. The form is intended to establish a comprehensive vendor profile for the Town of Palm Beach's purchasing records, enabling efficient communication and transaction processing. Contact methods include phone numbers, email addresses, cell phones, and web site information, demonstrating the municipality's desire for multiple communication channels with potential vendors and contractors.
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Text version
Please Take a Moment to Provide the following Company Information
Contact Information Form Purchasing Division 951 Okeechobee Rd.
West Palm Beach, FL 33401 Phone: 561-838-5406 Fax: 561-835-4688 Web: www.townofpalmbeach.com
Part 1 | Company Information
State: Zip:
Company Name:
DBA Name (If Applicable):
Physical Address (No P.O. Boxes):
Mailing Address (If Di�erent than Above):
City:
Owner’s Name(s):
Part 2 | Contact Information
O�ce Fax:
Alternate Contact:
Alternate Phone:
Web Site:
Alternate Email :
Part 3 | Purchase Orders
Contact for Issuing Purchase Orders:
Contact Phone:
Contact Email:
TOWN OF PALM BEACH
Alternate Contact Cell Phone:
Primary Contact:
Primary Contact Phone:
Primary Contact Cell Phone:
Primary Contact Email:
Emergency After Hours Contact:
Emergency After Hours Phone:
Emergency After Hours Email:
Part 4 | Accounts Receivable
Accounts Receivable Contact:
Contact Phone:
Contact Email:
TOWN OF PALM BEACH - Contact Information Form
File details come from the government source that posted it. Updated .