4-Uplift Vendor Packet 2026 - Blank.pdf
PDF 3 MB Posted
- Attached to
- School Uniform Program
- Solicitation number
- 2027-002
- Issued by
- Texas
About this file
This is a Vendor Request & Authorization Form and ACH Payment Request Form used by Uplift Education, a Texas-based school organization, to process new vendor applications for products and services. The form establishes the standardized procurement process through which academic departments request vendor services, requiring submission of vendor information, service descriptions, requesting department details, and the specific reason for vendor selection. Vendors may be selected through sole source justification, best value determination, existing cooperative purchasing agreements, competitive procurement, continuation of existing services, or grant requirements. The form requires vendors to specify the delivery method (on-campus, virtual, or hybrid), whether direct scholar contact is involved, and whether background checks or fingerprinting are required. All new vendor requests must be accompanied by supporting documentation including a completed vendor application packet, W-9 or W-8BEN-E form, certificate of insurance if applicable, conflict of interest documentation, proposal or quote, scope of work, budget approval confirmation, and background check documentation when applicable. Academic Directors must certify that the vendor is necessary to support instructional or operational needs and that funding has been verified and is available before submission to the Procurement department.
The form requires vendors to provide complete banking information for ACH payment processing, including bank name, routing number, account number, and a voided check. Vendors must submit the completed authorization form, signed by the Academic Director, along with all required documentation to Procurement@Uplifteducation.org. Funding sources must be identified and verified prior to vendor approval, and vendors may be grant-funded through sources such as the Malachi Jacobs Pencil Grant. The contract specifies that no services or purchases will commence until formal Procurement approval and issuance of an authorized Purchase Order or fully executed agreement are issued by Uplift Education. This procurement process applies to the School Uniform Program, an RFP intended to establish multi-year service price agreements with multiple qualified vendors to provide school uniforms across Uplift's multiple campuses in Texas, with awards based on evaluation of responsive and responsible bids to ensure competitive pricing and service accessibility.
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Other files
| File | Type | Posted |
|---|---|---|
| 3-Uplift Education Style-Guide.pdf | ||
| 2-Uplift Uniform Vendor Pricing Response Sheet.xlsx | XLSX spreadsheet | |
| 1-RFP 2027-002 School Uniforms.pdf |
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Text version
UPLIFT EDUCATION
Academic Director Vendor Request & Authorization Form Required Attachment to Vendor Application Packet
Vendor Information
Vendor Name: __________________________________________
Vendor Contact: __________________________________________
Service / Product Requested:
Requesting Department Information Academic Director: __________________________________________
Department: __________________________________________
Date Requested: __________________________________________
Reason for Vendor Selection
• ☐ Sole Source
• ☐ Best Value
• ☐ Existing Cooperative Purchasing Agreement
• ☐ Competitive Procurement Completed
• ☐ Continuation of Existing Services
• ☐ Grant Requirement
• ☐ Other: __________________________
Comments:
Funding Information Funding Source: __________________________________________
Budget Code: __________________________________________
Estimated Contract Amount: $ __________________________________________
Grant Funded: ☐ Yes ☐ No
Malachi Jacobs Pencil
Grant Name: __________________________________________
Service Information Service Start Date: __________________________________________
Service End Date: __________________________________________
Delivery Method: ☐ On Campus ☐ Virtual ☐ Hybrid
Direct Scholar Contact: ☐ Yes ☐ No
Background Check Required: ☐ Yes ☐ No
Fingerprinting Required: ☐ Yes ☐ No
Procurement Compliance Checklist
• ☐ Vendor Application Packet
• ☐ W-9 / W-8BEN-E
• ☐ Certificate of Insurance (if applicable)
• ☐ Conflict of Interest Documentation
• ☐ Proposal / Quote / Contract
• ☐ Scope of Work
• ☐ Budget Approval Confirmed
• ☐ Background Check Documentation (if applicable)
Academic Director Certification I certify that the requested vendor is necessary to support instructional or operational needs; funding has been verified and is available; all required documentation accompanies this request; and no services or purchases will begin until Procurement approval and issuance of an authorized Purchase Order or fully executed agreement by Uplift Education.
Authorization Printed Name: __________________________________________
Signature: __________________________________________
Date: __________________________________________
This form must accompany all new vendor requests submitted by the Academic Department. Submission of this form does not constitute vendor approval or authorization to begin work.
Bank Name:_________________________________________________________________________
Bank ID (ABA or Routing Number):_______________________________________________________
Bank Account Number:________________________________________________________________
Bank Contact Info:____________________________________________________________________
PLEASE ATTACH A BLANK VOIDED CHECK WITH THIS FORM.
3000 Pegasus Park Dr., Ste 1100 Email completed forms to: Procurement@Uplifteducation.org Dallas, TX 75247 For questions contact the Accounts Payable Dept. at 469-621-8500
Vendor ACH Payment Request Form
VENDOR/OWNER BANK ACH INFORMATION
COMMENTS
Authorized Requestor’s Signature:_______________________________________ Date:_________________
Print Name:__________________________________________ Title:_________________________________
Email Address:______________________________________ Contact Number:_____________________________
This form is to be used only for Vendors that request payment in the form of an ACH. For all other vendor changes, please contact the Uplift Procurement department by email at procurement@uplifteducation.org .
VENDOR/OWNER NUMBER:_________________________________________________________________
VENDOR/OWNER NAME:____________________________________________________________________
COMPANY ADDRESS:_______________________________________________________________________ Street City State/Zip
CONTACT PERSON:________________________________ PHONE NUMBER_____________________ mailto:Procurement@Uplifteducation.org mailto:procurement@uplifteducation.org
| APPLICANT AUTHORIZATION AND CONSENT FOR RELEASE OF INFORMATION -BLANK 24.25 |
| DPS_CCH_verification_form 24.25 |
| Uplift New Vendor Packet FY24.25 |
| Uplift New Vendor Blank FY24-25 |
| W9 Form Blank 22.23 |
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