ACH Vendor Enrollment Form.pdf
PDF 66 KB Posted
- Attached to
- Electrical Infrastructure Upgrade (Optics)
- Solicitation number
- SV0218-26
About this file
This is an ACH Vendor/Miscellaneous Payment Enrollment Form for vendors seeking to do business with UNICOR (Federal Prison Industries, Inc.). The form collects essential vendor registration and banking information required to process payments through automated clearing house (ACH) transactions.
Vendors must provide company identification details including physical address, contact information, email address for accounts receivable, telephone, and fax number. The form requires vendors to designate their business classification as either large or small and identify any applicable socioeconomic status including disadvantaged, woman-owned, service-disabled, or veteran-owned business designations. Banking information required includes SAM UEI Number, Tax Identification Number (TIN), nine-digit routing transit number, depositor account title, account number, and financial institution name. Regarding shipping terms, UNICOR's stated preference is FOB Destination with freight included in the price, as this facilitates accurate and timely payment processing. The form also requires vendors to confirm registration and current status in the System for Award Management (SAM) at https://www.sam.gov, which is a free federal-wide mandatory requirement (except for credit card vendors). Registered vendors must annually update their SAM profile when prompted via email notification.
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Text version
Company:
Physical Address:
City: State: Zip:
Contact:
Email Address:
Accounts Recievable Email:
Telephone: Fax:
Large: Small:
Disadvantaged: Woman Owned:
Service Disabled: Veteran Owned:
Yes: No:
SAM UEI NUMBER:
TAX Identification # (TIN):
Nine Digit Routing Transit Number:
Depositor Account Title:
Depositor Account Number:
Financial Institution Name:
Yes: No:
UNICOR, Federal Prison Industries, Inc.
ACH Vendor/Miscellaneous Payment Enrollment Form
Company:
(please check one)
Does UNICOR Pay Shipping?
Our preference is always FOB Destination (freight included in price)*
*FOB DST helps with accurate and timely payment as well*
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/ https://www.sam.gov/ https://www.sam.gov/ https://www.sam.gov/ https://www.sam.gov/ https://www.sam.gov/ https://www.sam.gov/
Table 1
| Company: |
| Physical Address: |
| City: |
| State: |
| Zip: |
| State_2: |
| Email Address: |
| Accounts Recievable Email: |
| Telephone: |
| Fax: |
| SAM UEI NUMBER: |
| TAX Identification TIN: |
| Nine Digit Routing Transit Number: |
| Depositor Account Title: |
| Depositor Account Number: |
| Financial Institution Name: |
| Check Box3: Off |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
| Check Box7: Off |
| Check Box8: Off |
| Check Box9: Off |
| Check Box10: Off |
| Check Box11: Off |
| Check Box12: Off |
File details come from the government source that posted it. Updated .