COG_Substitute_W9.pdf
PDF 172 KB Posted
- Attached to
- Infectious Medical Waste Disposal Services
- Solicitation number
- RFP #23092
- Issued by
- Greenville County, South Carolina
About this file
The document is a Substitute Form W-9 issued by the County of Greenville, South Carolina, designed to collect vendor tax and contact information for potential service providers. This specific form is associated with a solicitation for Infectious Medical Waste Disposal Services, where the county seeks proposals from vendors to provide pick-up and disposal of medical waste at various county locations. The contract is structured for an initial one-year term with the option of four additional annual renewals, allowing flexibility for the county to add or delete service locations as needed.
The form requires vendors to provide detailed information including legal name, tax identification number, entity tax classification, service type, and contact details. By completing this document, vendors certify their taxpayer identification, confirm they are not subject to backup withholding, and affirm their status as a U.S. citizen or entity. The form was revised in March 2022 and is specifically noted as not being interchangeable with the standard IRS Form W-9, highlighting the county's specific administrative requirements for potential medical waste disposal service providers.
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Other files
| File | Type | Posted |
|---|---|---|
| Infectious_Medical_Waste_Disposal_Services_(Addendum_#1_Revision).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 March 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 __ Partnership __ Medical or Veterinarian Service
__ LLC- Partnership __ C Corporation __ Legal/ Attorney Service
__ LLC- C-Corp __ S Corporation __ Rental of Real Property
__ LLC- S Corp __ Trust/Estate __ Products/ Services type______________
__ Other_____________________________________ __ 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.
Contact Information
Remittance 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: |
| LLCS Corp: |
| Products Services type: |
| Remittance 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 .