9-Vendor Registration Form.pdf
PDF 288 KB Posted
- Solicitation number
- 26-002-30
- Issued by
- Arizona
About this file
This document is a Vendor Registration and Update Form for Creighton Elementary School District #14 located in Phoenix, Arizona. The form is designed for potential vendors to provide comprehensive contact and business information to the school district in order to be considered for future purchase orders and procurement opportunities. The form requires detailed information including legal business name, contact details, address, types of goods or services provided, tax status, and requires vendors to acknowledge several key compliance and communication guidelines.
The form mandates that vendors submit a W-9 form along with this registration document, and can be returned via email to rayers@creightonschools.org or mailed to the Purchasing Department at 2702 E. Flower St., Phoenix, AZ 85016. Vendors must affirm they will not provide products or services without an authorized purchase order, will direct all communication about purchase orders to the Procurement Office, include purchase order numbers on invoices, and submit invoices directly to Accounts Payable. The form also requires vendors to disclose any relationships with CSD employees or governing board members, and confirms that registration does not guarantee contractual awards or inclusion on the district's bidder list.
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Text version
R e v 9 / 2 6 / 2 4
CREIGHTON ELEMENTARY SCHOOL DISTRICT #14
VENDOR REGISTRATION AND UPDATE FORM
ORDER INFORMATION PAYMENT INFORMATION
LEGAL NAME OF ORGANIZATION / INDIVIDUAL LEGAL NAME OF PAYEE
STREET ADDRESS STREET ADDRESS
STREET ADDRESS 2 STREET ADDRESS 2
CITY CITY
STATE ZIP STATE ZIP
PHONE NUMBER W/ EXTENSION FAX NUMBER PHONE NUMBER W/ EXTENSION FAX NUMBER
CONTACT NAME CONTACT NAME
CONTACT EMAIL FOR QUOTES EMAIL ADDRESS FOR ACCOUNTS RECEIVABLE
EMAIL ADDRESS FOR PURCHASE ORDERS DOES YOUR COMPANY ACCEPT PURCHASE ORDERS?
YES NO
WEB ADDRESS ARE YOU ON A COOPERATIVE CONTRACT?
DO YOU REMIT ARIZONA STATE SALES TAX?
YES NO
DOES YOUR COMPANY PROVIDE:
GOODS SERVICES BOTH
PLEASE DESCRIBE:
ARE YOU A CSD EMPLOYEE?
YES NO IF YES, EXPLAIN:
RELATIVE OF CSD EMPLOYEE?
YES NO IF YES, EXPLAIN:
MEMBER OR RELATIVE OF CSD GOVERNING BOARD?
YES NO IF YES, EXPLAIN:
VENDOR ACKNOWLEDGEMENTS - BY SIGNING BELOW, I HEREBY ACKNOWLEDGE 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 State statutes and Federal equal opportunity and non-discrimination requirements and conditions of employment in accordance with A.R.S. Title 41, Chapter 9, Article 4 and Executive Order Number 75-5 dated April 28, 1975.
4. Filing of a Vendor Registration Application provides information only and does not constitute an assumed obligation by Creighton Elementary School District
(CSD) to guarantee contractual awards or agreements to my organization.
5. Updating information contained on this form is solely the duty of my organization.
6. My organization will not provide any product or service without first having in our possession an authorized CSD Purchase Order. No products or 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 or service provided without an authorized Purchase Order is not the responsibility of CSD and that I will have to obtain payment from the individual requestor.
7. My organization will direct all communication regarding CSD Purchase Orders to the CSD Procurement Office.
8. My organization will provide the Purchase Order number on all invoices submitted to CSD. I understand that invoices received without this information will not be paid.
9. My organization will submit all invoices directly to CSD Accounts Payable and not to the requesting department or school.
10. This form allows CSD to issue Purchase Orders and payments. It does not provide inclusion in the Creighton Elementary School District Vendor’s Bid List.
PRINTED OR TYPED NAME TITLE
SIGNATURE DATE
**W-9 form must accompany this form** Please return form via Email to: rayers@creightonschools.org or mailed as follows:
Creighton School District #14, c/o Purchasing Dept., 2702 E. Flower St., Phoenix, AZ 85016 mailto:rayers@creightonschools.org
File details come from the government source that posted it. Updated .