Attachment 6 - VENDOR REQUEST FORM.pdf

DocNo. 0705180201 AOC Form 34-04-01 December 2007

ARCHITECT OF THE CAPITOL VENDOR REQUEST FORM

SECTION I. To Be Completed By AOC Personnel Before Sending To The Vendor

Name (Printed and Signature) of AOC Personnel Requesting Vendor:

Signature certifies that this request is for addition or modification of a vendor for the purposes of conducting valid business with the Architect of the Capitol.

AOC Personnel Phone No. Vendor Number (required for modifications to a vendor already on file):

Vendor Name

Vendor Phone No

Name of Vendor Personnel to be Sent This Form

Vendor Fax No.

SECTION II. To be completed by vendor. For assistance on SECTION II, call (202) 226-2557.

Official Vendor Name:

Mailing Address:

Physical Address:

Vendor’s Remittance Name and Address:

Vendor Phone No.:

Vendor Fax No.: Vendor DUNS No.:

Type of Contractor (See Attached Page For Information) If small business, check all that apply in this column If not a small business, check only one of the below categories Small Business Concern Large Business HUBZone Small Business Historically Black College/University Small Disadvantaged Business Educational Institution 8(a) Program Participant JWOD AbilityOne Non Profit Agency Service Disabled Veteran Owned Other Non Profit Organization Veteran Owned Small Business Other Entities (State/Local/Federal Gov.)

Woman-Owned Small Business Printed Name and Title of Vendor Representative

Signature of Vendor Representative

Telephone No.:

E-mail Address Date:

SECTION III: For AOC Use Only

Signature and Date of Procurement Staff Entering Data

Signature and Date of Accounting Staff Verifying Financial Data Entered

INSTRUCTIONS TO VENDORS

Complete the attached W-9 IRS form. An SSN or EIN must be provided. W-9 is also available at www.irs.gov under “More Forms and Publications”.

The AOC makes payment via Electronic Funds Transfer (EFT). Please complete the enclosed SF 3881 ACH VENDOR/ MISCELLANEOUS PAYMENT ENROLLMENT FORM. This form is also available at www.gsa.gov under “Forms Library” “Standard Forms”.

Upon completion of the forms, fax to: Procurement Division (202) 225-3221 or e-mail as PDF attachments to AOCProcurement@aoc.gov. To verify receipt, call (202) 226-2557.

http://www.irs.gov/ http://www.gsa.gov/ mailto:AOCProcurement@aoc.gov

DocNo. 0705180201 AOC Form 34-04-01 December 2007

TYPE OF CONTRACTOR

A small business is one that is organized for profit, has a place of business in the United States, and does not exceed the size standard for its industry. It may be a sole proprietorship, partnership, corporation, or any other legal entity. An entity that is organized for profit, has a place of business in the United States, and exceeds the size standard for its industry is a large business. An entity that is not organized for profit is a nonprofit organization, e.g., the American Red Cross, universities, and foundations. An entity organized for profit that is not in the United States is a foreign contractor.

Small disadvantaged business, women-owned small business, veteran-owned small business, service-disabled veteran-owned small business, and HUBZone small business are each subsets of small business. Generally, not less than 51% of the business must be owned by the type of individual described in order to be considered of that category, e.g., in order to be a veteran-owned small business, not less than 51% of the business must be owned by one or more veterans with the management and daily business operations controlled by one or more veterans. Small disadvantaged businesses and HUBZone small businesses require certification by the U. S.

Small Business Administration. For help in determining the type of contractor you are please visit the following link: http://www.sba.gov/gopher/Government-Contracting/Size/ or call AOC Procurement Policy at

(202) 226-1407.

http://www.sba.gov/gopher/Government-Contracting/Size/