7-Supplier Contact List Designation Form 09-2022.doc
DOC document 656 KB Posted
- Attached to
- Mathematics Professional Learning Services
- Solicitation number
- RFP 26025TCG
- Issued by
- Clark County, Nevada
About this file
This is a Supplier Contact List Designation Form issued by the Clark County School District Purchasing Department located in Las Vegas, Nevada. The form serves as an administrative tool to establish and maintain authorized contact information for vendors conducting business with the District.
The form is designed to collect and update company contact details across multiple functional roles. Part 1 requests confirmation of basic company information including legal name, doing-business-as designation, vendor number, address, telephone, and email. Part 2 allows suppliers to designate or modify up to two principal contacts, one sales representative/account manager, two accounts receivable contacts, and one technical contact. Each contact role carries specific responsibilities: principal contacts serve as the primary communication liaison and have authority to update company information including banking details for payment processing; account representatives/managers handle purchase order and invoice transactional inquiries; accounts receivable contacts manage invoice delivery and payment status questions; and technical contacts address file delivery issues, system outages, and technical concerns. For each contact, the form requires name, title, business address, phone number, email, and confirmation of whether the address matches the company's main location. The District indicates it will rely on the information provided until receiving written notice of changes and sufficient time to process updates.
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Other files
| File | Type | Posted |
|---|---|---|
| 4-supplier-application-update-form-4-2025-fillable.pdf | ||
| 5-RFP 26018TCG Customer Reference Form.docx | DOCX document | |
| 8-RFP 26025TCG Mathematics Professional Learning Services 7-10-25.pdf | ||
| 2-Updated Supplier Federal 2CFR200 Certification Form 10.20.23.docx | DOCX document | |
| 3-W-9 2024.pdf | ||
| 6-RFP 26018TCG Proposal Submittal Form.docx | DOCX document | |
| 1-Disclosure Form 3-15-11.docx | DOCX document |
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Text version
file_0.jpg file_1.wmf
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 file_2.wmf
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 file_3.wmf
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 |
Sales Rep/Account Manager file_4.wmf
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
Accounts Receivable #1 file_5.wmf
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
Accounts Receivable #2 file_6.wmf
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 |
Technical Contact file_7.wmf
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 |
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