9-Vendor Information Form - 2024.pdf

This document is a Vendor Information Form from the County of Bergen, specifically from the Department of Administration and Finance, Division of the Treasurer, located in Hackensack, New Jersey. The form is designed for potential vendors to provide comprehensive company and business information for consideration as a county supplier. The two-page document includes sections for basic vendor contact details, remittance address information, and business classification data.

The form requires vendors to provide key details such as company name, address, contact information for an authorized official, and preferences for purchase order communication. Additionally, vendors must classify their business type, including options for small business, minority-owned, women-owned, and veteran-owned designations, as well as their IRS classification such as sole proprietorship, corporation type, partnership, or tax-exempt organization. The form concludes with a certification statement where the vendor must print their name and provide a signature, affirming the accuracy of the submitted information.