COG_Sub_W9_.pdf
PDF 170 KB Posted
- Attached to
- Infectious Medical Waste Disposal Services
- Solicitation number
- RFP #27003
- Issued by
- Greenville County, South Carolina
About this file
This document is a Substitute Form W-9 issued by the County of Greenville in South Carolina, revised October 2022, for use in connection with the county's Infectious Medical Waste Disposal Services procurement. The form requires prospective vendors to provide standard taxpayer identification information including legal name, Taxpayer Identification Number (TIN), business address, and entity tax classification. Vendors must specify the type of service being provided, with options including medical or veterinarian services, legal/attorney services, rental of real property, or products/services. The form also requires payment remittance information including a contact name, telephone number, fax number, and email address. The document emphasizes that failure to provide the U.S. Taxpayer Identification Number in a timely manner could prevent or delay payment from the County of Greenville.
The form requires vendors to certify under penalties of perjury that the TIN provided is correct, that they are not subject to backup withholding by the Internal Revenue Service, and that they are a U.S. citizen or other U.S. person. The County of Greenville has specified that the IRS Form W-9 will not be accepted as a substitute for this county-specific form, making completion of this Substitute Form W-9 a mandatory requirement for all vendors seeking to contract with Greenville County for infectious medical waste disposal services at various county locations including the Detention Center, EMS, and Animal Care facilities.
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Other files
| File | Type | Posted |
|---|---|---|
| Infectious_Medical_Waste_Disposal_Services.pdf | ||
| Sample_Services_Agreement.pdf |
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Text version
COUNTY OF GREENVILLE SUBSTITUTE FORM W-9
(IRS Form W-9 will not be accepted in lieu of this form) Revised October 2022
Legal Name (as shown on tax return) DBA/Trade Name
Taxpayer Identification Type TIN (Must match legal name)
__ SSN __ EIN/FIN ________________________
Legal Address (number, street & apt. or suite no.) City, State & Zip code
Entity Tax Classification (Choose only one) Service Provided (Must select a type)
__ Individual/Sole Proprietorship or Single-member LLC __ Medical or Veterinarian service
__ Partnership __ LLC-Partnership __ Legal /Attorney Service
__ C Corporation __ LLC - C- Corp __ Rental of Real Property
__ S Corporation __ LLC- S - Corp __ Products / Services type _____________
__ Other __ Trust /Estate ________________________________
_______________________________________ __ Other (Specify) _____________________
The U.S. Taxpayer Identification Number is being requested per U.S. tax law. Failure to provide in a timely manner could prevent or delay payment.
Payment Remittance Information
Address (number, street & apt. or suite no.) City, State & Zip code
Contact Name Telephone #
Fax # E-mail
Under penalties of perjury, I certify that: 1) The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me);and
2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3) I am a U.S. citizen or other U.S. person.
Sign Here Date
| Legal Name as shown on tax return: |
| DBATrade Name: |
| TIN Must match legal name: |
| Legal Address number street apt or suite no: |
| City State Zip code: |
| undefined: |
| Products Services type: |
| Other: |
| Other Specify: |
| Address number street apt or suite no: |
| City State Zip code_2: |
| Contact Name: |
| Telephone: |
| Fax: |
| Email: |
| Sign Here: |
| Date: |
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File details come from the government source that posted it. Updated .