ACH Vendor Enrollment Form 2022.pdf
PDF 107 KB Posted
- Attached to
- Fabric JROTC
- Solicitation number
- CT2368-25
About this file
This is a vendor enrollment form for ACH (Automated Clearing House) and miscellaneous payments for UNICOR, Federal Prison Industries, Inc. The form collects basic company information including physical address, contact details, and business classification data such as large/small business status and various certifications (disadvantaged, woman-owned, service-disabled veteran-owned, veteran-owned business enterprise).
The form requires financial information for electronic payment processing, including DUN & Bradstreet number, Tax Identification Number (TIN), nine-digit routing transit number, depositor account details, and financial institution information. It addresses shipping preferences, with UNICOR preferring FOB Destination terms where freight costs are included in pricing to facilitate accurate and timely payments. The form also requires confirmation of registration in the System for Award Management (SAM), which is a federal-wide mandatory requirement for vendors (except credit card vendors), with annual profile updates required when prompted via email at https://www.sam.gov.
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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 .