9-Vendor Registration Form - Includes Conflict of Int and W9 Link.pdf

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