Attachment 5 - GSA Fleet System Account Form.pdf
PDF 130 KB Posted
- Attached to
- Air Force - Potable Water Trucks
- Solicitation number
- 47QMCA26Q0050
- Issued by
-
GSA Federal Acquisition Service
About this file
This is a GSAfleet.gov Vendor Company Request Form template used for vendor registration and account creation for GSA fleet-related solicitations.
The form collects comprehensive vendor information required to establish a GSAfleet.gov account, organized into several categories. Company identification requires vendor name, Unique Entity Identifier (UEI), physical address, and country. Payment information includes a separate payment street address with city, state, and country. Contact details encompass vendor phone and fax numbers (with country codes), website, and a designated point of contact with corresponding email and phone information. Vendor classification requires selection of supplier type (Dealer-Reseller or Original Equipment Manufacturer) and store type (Corporate, Dealership, Franchise, or Independent). The form also requests vehicle makes the vendor represents (such as Ford, Nissan, Jeep, or Chevrolet). Administrative contacts must be specified with vendor administrator name, email, and phone number. The form includes fields for up to five email addresses each for certificate of origin notifications and order transmission purposes. All fields marked with an asterisk are mandatory for account creation. The form requires entry of a solicitation number and program name at the top but does not specify response deadlines, pricing terms, or contract performance details, as it functions solely as a registration mechanism for vendors seeking to participate in GSA fleet solicitations.
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Text version
GSAfleet.gov Vendor Company Request Form
Solicitation Number: Program:
Please complete the following fields required to create an GSAfleet.gov account for this announcement. Required fields are marked with an asterisk (*).
Vendor name*
Unique Entity Identifier (UEI)*
Physical street address*
Physical street address line 2
City*
State*
Country*
Payment street address*
Payment street address line 2*
City*
State*
Country*
Vendor phone (including country code)*
Vendor fax (including country code)
Vendor website
Vendor point of contact*
Vendor point of contact email
Vendor point of contact phone (including country code) Type of supplier (choose one)*
Vendor store type (choose one)*
Vendor makes (add as many as needed) i.e.
Ford, Nissan, Jeep, Chevrolet* Certificate of origin notifications (add up to five email addresses)*
Order transmission email addresses (add up to five email addresses) Vendor administrator name (first and last)*
Vendor administrator email*
Vendor administrator phone (including country code)*
Dealer - Reseller Original Equipment Manufacturer Corporate Dealership Franchise Independent
| Solicitation Number: |
| Program: |
| Vendor name: |
| Unique Entity Identifier UEI: |
| Physical street address: |
| Physical street address line 2: |
| City: |
| State: |
| Country: |
| Payment street address: |
| Payment street address line 2: |
| City_2: |
| State_2: |
| Country_2: |
| Vendor phone including country code: |
| Vendor fax including country code: |
| Vendor website: |
| Vendor point of contact: |
| Vendor point of contact email: |
| Vendor point of contact phone including country code: |
| Vendor makes add as many as needed ie Ford Nissan Jeep Chevrolet: |
| Certificate of origin notifications add up to five email addresses: |
| Order transmission email addresses add up to five email addresses: |
| Vendor administrator name first and last: |
| Vendor administrator email: |
| Vendor administrator phone including country code: |
| Type of supplier (choose one): Dealer - Reseller |
| Vendor store type (choose one): Corporate |
File details come from the government source that posted it. Updated .