ACH Vendor Enrollment Form 2022.pdf

PDF 107 KB Posted

Attached to
Hook and Loop Federal contract opportunity
Solicitation number
CT2372-25
Issued by
Department of Justice Bureau of Prisons Correctional Facilities

About this file

The document is an ACH Vendor/Miscellaneous Payment Enrollment Form for UNICOR (Federal Prison Industries, Inc.). The form is designed to collect comprehensive vendor information, including company details, business classification (such as small business, disadvantaged, woman-owned, or veteran-owned), and critical financial data like DUN & Bradstreet number, Tax Identification Number (TIN), and banking information.

The form emphasizes a key federal requirement of being registered and current in the System for Award Management (SAM.gov), which is mandatory for most federal vendors and free to enroll. It also notes a preference for FOB Destination shipping, where freight costs are included in the price, which helps facilitate accurate and timely payment. This specific form appears to be associated with a federal contract opportunity for "Hook and Loop" products issued by the Department of Justice Bureau of Prisons Correctional Facilities, with the solicitation number CT2372-25.

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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:

DUN & Bradstreet #:

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/

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 .