5-Supplier Contact List Designation Form 09-2022.pdf

126 KB Posted

Attached to
Beverages for Student Meals
Solicitation number
26027AIT
Issued by
Clark County, Nevada

About this file

Written by GovTribe AI ·

This is a Supplier Contact List Designation Form used by the Clark County School District's Purchasing Department to establish and maintain authorized business contacts for vendor companies. The form is designed to collect and update contact information for suppliers conducting business with the District, allowing the District to manage communications regarding various business activities including purchase orders, invoices, payment inquiries, and technical support. The form remains valid until the District receives written notice of changes and has reasonable time to process them.

The form captures six categories of contact roles: two principal contacts (the primary representatives designated to receive District communications and authorized to update company information including banking details for payments), a sales representative or account manager (authorized to request and provide purchase order and invoice transaction data), two accounts receivable contacts (responsible for providing invoices and inquiring about payment status), and a technical contact (responsible for requesting file resends, inquiring about file names and delivery information, and reporting system issues). For each contact, the form requires the individual's name and title, business address (with an option to use the company address), business phone number, city/state/zip code, and business email address. Suppliers can add or delete contacts as needed through the form's designated fields.

View the file

Other files

File Type Posted
7-26027AIT Beverages for Student Meals - Proposal.docx DOCX document
9-26027AIT Beverages for Student Meals - Attachment Table A (BT-78TY).xlsx XLSX spreadsheet
1-Supplier Application Update Form 4-2025.docx DOCX document
4-Updated Supplier Federal 2CFR200 Certification Form 10.20.23.pdf PDF
6-Food Sv RFP T Cs Pur-RFP-002 8-18-25.doc DOC document
3-Public Disclosure Form 2-17-26.docx DOCX document
2-Form W-9 (Rev.pdf PDF
8-26027AIT Beverages for Student Meals BOL Attachment B (BT-78QY).xlsx XLSX spreadsheet

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Supplier Contact List Designation Form Purchasing Department

4212 Eucalyptus Avenue Bldg. 7 Las Vegas, NV 89121

Telephone: (702) 799-5225 Fax: (702) 799-5018

This form provides the Clark County School District with a list of contacts authorized to conduct various business activity on behalf of your company.

We can rely on this form until we receive written notice of a change and we have had reasonable time to act on it.

Part 1: Confirm your company details

Name:

DBA:

Vendor Number (CCSD Use Only) Address City, State and Zip Code Telephone Email

Part 2: Add or Change contacts

Use this section to add or change principal contact, account representative/manager, accounts receivable and technical contact.

The principal contact is the person your company designates as supplier emails and phone calls. They have the authority to add/ update company information including bank account information for payments.

An account representative/ manager can request and provide purchase order and invoice transactional data.

An account receivable contact can provide invoices and inquire about payment status.

A technical contact can request file resends and inquire about files names and delivery information, incoming files and system outage and issues.

Principal Contact #1

Name and title:

What do you want to do for this contact? Add Delete

Is the contact’s address the same as the company address? Yes No

Business address Business phone City, State, Zip code Business email

Principal Contact #2

Sales Rep/Account Manager

Accounts Receivable #1

Accounts Receivable #2

Technical Contact

Add: Off
Delete: Off
Yes: Off
No:
Add_2: Off
Delete_2: Off
Yes_2: Off
No_2:
Add_3: Off
Delete_3: Off
s address the same as the company address: Off
Yes_3:
ness address_3:
ness phone_3:
p code_3:
l_3:
Add_4: Off
Delete_4: Off
s address the same as the company address_2: Off
Yes_4:
ness address_4:
ness phone_4:
p code_4:
l_4:
Add_5: Off
Delete_5: Off
s address the same as the company address_3: Off
Yes_5:
ness address_5:
ness phone_5:
p code_5:
l_5:
Add_6: Off
Delete_6: Off
s address the same as the company address_4: Off
Yes_6:
ness address_6:
ness phone_6:
p code_6:
l_6:
Name:
DBA:
Vendor Number:
Address:
City, State Zip:
Telephone:
Email:
Name & Title:
Business address:
Business phone:
Business City State Zip:
Business Email:
Contact 2 Name & Title:
Business address_2:
Business City State Zip code_2:
Business phone_2:
Business Email2:
Rep Name & Title:
AR Name & Title:
AR 2 Name & Title:
Tech Contact Name & Title:

File details come from the government source that posted it. Updated .