6-Vendor Registration Form - Includes Conflict of Int and W9 Link.pdf
PDF 47 KB Posted
- Attached to
- Criminal Justice Equipment & Instructional Aids
- Solicitation number
- IFB 26-02-30
- Issued by
- Maricopa County, Tucson City, Arizona
About this file
This is a Vendor Registration Form from Tolleson Union High School District #214 (TUHSD) in Arizona that allows organizations and individuals to register as approved vendors for potential purchase order opportunities. The form collects comprehensive vendor information including legal organization name, order and remittance mailing addresses, contact details for sales and billing personnel, and requires vendors to specify whether they remit Arizona state sales tax and accept purchase orders. Vendors must also complete a conflict of interest statement disclosing any relationships with TUHSD employees or governing board members, describe the goods and services they offer, and acknowledge compliance with various operational requirements including proper invoice submission procedures and communication protocols.
The registration process requires submission of both the completed form and a current IRS W-9 form to TUHSD's Purchasing Department, with vendor acknowledgements covering 11 specific conditions including authorization requirements, accuracy of information, compliance with applicable regulations, and operational procedures for purchase orders and invoicing. The form explicitly states that registration provides information only and does not guarantee contractual awards, with vendors required to register separately at the district's procurement portal for inclusion in bid opportunities. All invoices must include purchase order numbers and be submitted directly to accounts payable, with goods and services required to be received by June 30 of each fiscal year and vendors responsible for following up on invoice payments within 30 days.
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Text version
VENDOR REGISTRATION FORM
https://www.tuhsd.org/purchasing
ORDER INFORMATION REMITTANCE ADDRESS INFORMATION
LEGAL NAME OF ORGANIZATION / INDIVIDUAL LEGAL NAME OF PAYEE
ORDER MAILING ADDRESS PAYMENT MAILING ADDRESS
ORDER MAILING ADDRESS 2 PAYMENT MAILING ADDRESS 2
ORDER CITY PAYMENT CITY
ORDER STATE ORDER ZIP PAYMENT STATE PAYMENT ZIP
ORDER PHONE NUMBER W/ EXT ORDER FAX NUMBER PAYMENT PHONE NUMBER W/ EXT PAYMENT FAX NUMBER
SALES CONTACT NAME BILLING CONTACT NAME
SALES EMAIL ADDRESS BILLING EMAIL ADDRESS
EMAIL ADDRESS FOR PURCHASE ORDERS WEBSITE ADDRESS
DO YOU REMIT ARIZONA STATE SALES TAX? DOES YOUR COMPANY ACCEPT PURCHASE ORDERS?
YES NO YES NO
NAME OF TUHSD STAFF WITH WHOM YOU ARE CURRENTLY WORKING: VENDOR CONFLICT OF INTEREST STATEMENT
ARE YOU A TUHSD DISTRICT EMPLOYEE?
YES IF YES, EXPLAIN:
A RELATIVE OF A TUHSD DISTRICT EMPLOYEE?
YES NO IF YES, EXPLAIN:
A MEMBER OR RELATIVE OF DISTRICT GOVERNING
YES NO IF YES, EXPLAIN:
DESCRIBE GOODS/SERVICES OFFERED:
VENDOR ACKNOWLEDGEMENTS BY SIGNING BELOW, I CERTIFY THAT:
1. I am duly authorized to certify the information requested herein.
2. To the best of my knowledge, the elements of the information provided herein are accurate and true as of this date.
3. My organization will comply with all applicable State statutes and Federal regulations that govern purchases from my company.
Filing of a Vendor Registration Application supplies information only and does not constitute an assumed obligation by Litchfield Elementary School District (TUHSD) to guarantee contractual awards or agreements to my organization.
4.
5. Updating information contained on this form is solely the duty of my organization.
6. My organization will not provide any product/service without first having in our possession an authorized TUHSD Purchase Order. No products/services will be provided based on a verbal promise of a Purchase Order or with the submission of a requisition for a Purchase Order. I understand that payment for any product/service provided without an authorized Purchase Order is not the responsibility of TUHSD and that I will have to obtain payment from the individual requestor.
7. My organization will direct all communication regarding TUHSD Purchase Orders to the TUHSD Purchasing Department.
8. My organization will provide the Purchase Order number on all invoices submitted to TUHSD I understand that invoices received without this information will not be paid. Email invoices to AP@tuhsd.org.
9. My organization will submit all invoices directly to TUHSD Accounts Payable and not to the requesting department or school.
10. All goods/services must be received by June 30 of each fiscal year. I understand that it is my responsibility to follow up on payment of invoices within 30 days.
11. This form allows TUHDS to issue PO's and payment to you. It does not provide inclusion in TUHSD Bid List. Register separately at https://tollesonuhsd.bonfirehub.com/portal/?tab=openOpportunities.
PRINTED OR TYPED NAME TITLE
SIGNATURE DATE
Please return this Vendor Registration Form and a current IRS W-9 (Click Here) Form to:
Tolleson High School District #214
Attn: Purchasing
9801 West Van Buren St.
Tolleson AZ 85353
Email: vendorforms@tuhsd.org
Questions? 623-478-4000
Last Update 6/11/2025 https://www.tuhsd.org/purchasing mailto:AP@tuhsd.org https://tollesonuhsd.bonfirehub.com/portal/?tab=openOpportunities https://www.irs.gov/pub/irs-pdf/fw9.pdf mailto:vendorforms@tuhsd.org
File details come from the government source that posted it. Updated .