ACH Vendor Enrollment Form 2022.pdf
PDF 113 KB Posted
- Attached to
- DCMA Pease Repair
- Solicitation number
- SICG030-25
About this file
The document is an ACH Vendor/Miscellaneous Payment Enrollment Form for UNICOR, Federal Prison Industries, Inc. The form requires vendors to provide comprehensive company and financial information, including physical address, contact details, business classification (such as small business, woman-owned, veteran-owned), and banking details. Vendors must also confirm their registration status in the System for Award Management (SAM.gov), which is a federal-wide mandatory requirement that is free to enroll and requires annual profile updates.
The form specifies key financial and shipping preferences, including a preference for FOB Destination (freight included in price) to facilitate accurate and timely payment. Vendors must provide their Unique Entity ID, Tax Identification Number (TIN), Nine Digit Routing Transit Number, depositor account information, and financial institution details. The form is associated with a DCMA Pease Repair solicitation involving water damage repair at a Defense Contract Management Agency location, with the opportunity managed by the Department of Justice Bureau of Prisons Correctional Facilities.
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Text version
Company:
Physical Address:
City: State: Zip:
Contact:
Email Address:
Telephone: Fax:
Large: Small:
Disadvantaged: Woman Owned:
Service Disabled: Veteran Owned:
Yes: No:
Unique Entity ID #:
TAX Identification # (TIN):
Nine Digit Routing Transit Number:
Depositor Account Title:
Depositor Account Number:
Financial Institution Name:
Yes: No:
Our preference is always FOB Destination (freight included in price)*
*FOB DST helps with accurate and timely payment as well*
Does UNICOR Pay Shipping?
ACH Vendor/Miscellaneous Payment Enrollment Form UNICOR, Federal Prison Industries, Inc.
Company:
(please check one)
Registered And Current In System For Award Management - This is a Federal wide mandatory reuiqrement that is free to enroll (not required for credit card vendors)
Once enrolled you will have to anually update your profile when prompted via email.
https://www.sam.gov https://www.sam.gov/ kschwinn Highlight
Sheet1
| Company: |
| Physical Address: |
| City: |
| State: |
| Zip: |
| Contact: |
| Email Address: |
| Telephone: |
| Fax: |
| DUN Bradstreet: |
| TAX Identification TIN: |
| Nine Digit Routing Transit Number: |
| Depositor Account Title: |
| Depositor Account Number: |
| Financial Institution Name: |
| Company-Small: Off |
| Company-Large: Off |
| Company-Disadvantaged: Off |
| Company-Womanowned: Off |
| SysAward-Yes: Off |
| SysAward-No: Off |
| Company-Disabled: Off |
| Company-Veteranowned: Off |
| UnicorPayShip-Yes: Off |
| UnicorPayShip-No: Off |
File details come from the government source that posted it. Updated .