5-Vendor Information Form.docx

DOCX document 29 KB Posted

Attached to
Quarry Products Delivered Annual Contract
Solicitation number
2026-SW-11
Issued by
Clayton County, Georgia

About this file

This Vendor Information Form is used by the Clayton County Water Authority (CCWA) in Morrow, Georgia to register vendors and suppliers in its financial database system and document applicable business designations. The form is directly related to CCWA's annual contract solicitation for quarry products delivered over a twelve-month period. Vendors responding to this procurement opportunity must complete the form to provide essential company information, including vendor name, principal contact details, mailing address, and remittance address for payment purposes.

The form requires vendors to specify payment terms and payment method preferences, with NET 30 terms as the standard option and payment available via paper check or ACH transfer. Vendors must also indicate applicable business classifications, including Small Local Business Enterprise (SLBE), Women Business Enterprise (WBE), Minority Business Enterprise (MBE), Disadvantaged Business Enterprise (DBE), other Small Business Enterprise (SBE) designations, or Veteran-Owned Business status. A critical requirement is that the vendor name on the form must match exactly with the submitted W-9 Form and the name that will appear on invoices to ensure proper financial processing and record-keeping within CCWA's system.

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Text version

CLAYTON COUNTY WATER AUTHORITY

PROCUREMENT AND COMPLIANCE

1600 BATTLE CREEK ROAD | MORROW, GEORGIA 30260

Phone: (770) 960-5223 | Web Site: www.ccwa.us

VENDOR INFORMATION FORM

VENDOR INFORMATION FORM

Purpose of this Form: The Vendor Information Form is used by the Clayton County Water Authority (CCWA) to add Vendors/Suppliers to its financial database system and add business designations when applicable.

Important Note: What name will appear on the Invoice? Invoice name shall be reflected on the Vendor Information Form and match the W-9 Form.

PURCHASING DATA

NIGP CODE(s):

CCWA REQUESTING DEPARTMENT CONTACT:

VENDOR INFORMATION

VENDOR NAME:

PRINCIPAL CONTACT:
EMAIL ADDRESS:
PHONE NO.
MAILING ADDRESS
REMIT TO ADDRESS
Street
Street
City
City
State
Zip Code
State
Zip Code

PAYMENT REMITTANCE INFORMATION

PAYMENT TERMS:

NET 30

PAYMENT TYPE:

PAPER CHECK

ACH PAYMENT (If selected, ACH Authorization Form will be emailed to the awarded vendor).

BUSINESS CLASSIFICATION

CCWA SLBE WBE MBE DBE Other SBE Veteran-Owned Business image1.png

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