RCS Vendor Information Form Fillable rev Oct 2024.pdf
PDF 195 KB Posted
- Attached to
- PK 53 Science Rooms
- Solicitation number
- FRS11514
- Issued by
- Calhoun County, Riverview City, Michigan
About this file
The document is a Vendor Information form from Rochester Community Schools (RCS), designed to collect comprehensive details from potential vendors seeking to do business with the district. The form requires vendors to provide their legal business name, contact information, tax identification details, and critical information about their potential interactions with the school district, including whether they will have direct contact with students and if they have previously been employed by a public school district in Michigan.
The form outlines specific payment and purchase order protocols, including that orders over $500 will only be processed after receiving a valid RCS purchase order, and all invoicing must be directed to RCS Accounts Payable. Vendors must choose a payment method (ACH or check mailed via USPS) and provide detailed remittance information. The document emphasizes that any changes to vendor information must be submitted in writing to the RCS Purchasing Department, and the form must be accompanied by a completed IRS W-9 form to ensure proper payment processing.
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Text version
ROCHESTER COMMUNITY SCHOOLS
VENDOR INFORMATION
Vendor Legal Name:
Doing Business As:
TIN/EIN: or SSN:
State: Zip:
State: Zip:
Date:
Title:
»»»»»»»»»»This document MUST accompany a completed IRS W-9 form to ensure proper payment.««««««««««
Vendor Email to Send Purchase Orders:
Vendor Email to Send Payment Inquiries:
Vendor Phone: Vendor Fax:
Will vendor provide a service which comes in direct contact with students? (YES or NO)
If yes, what type of service will be provided involving students?
Are you currently, or have you ever been, employed by a public school district in MI? (YES or NO)
PURCHASE ORDER INFORMATION
Printed Name:
PAYMENT INFORMATION (Remit To)
AUTHORIZATION
Signed:
By completing this form, Vendor acknowledges all of the following:
»Orders over $500 will only be filled AFTER receipt of a valid RCS purchase order. Orders over $500 filled without a valid RCS purchase order are NOT the liability of the District.
»All invoicing must be directed to RCS Accounts Payable, 52585 Dequindre Road, Rochester, MI 48307 or ap@rochester.k12.mi.us.
»Any changes to the above information must be provided IN WRITING to the RCS Purchasing Department at purchasing@rochester.k12.mi.us.
rev 10/2024
Payment Method (choose one):
Info Below Same as PO Info Above:
Address 1:
Address 2:
City:
Contact Name:
Contact Email:
Contact Phone:
ACH (AR email address and bank letter are required. Please include/attach.)
Check mailed via USPS
Address 1:
Address 2:
City:
Contact Name:
Contact Email:
Contact Phone:
Sheet1
| DBA: |
| SOCIAL SECURITY NUMBER: |
| EMAIL ADDRESS TO SEND PURCHASE ORDERS: |
| EMAIL ADDRESS FOR PAYMENT INQUIRIES: |
| PHONE #: |
| FAX #: |
| LEGAL NAME: |
| PURCHASE ORDER ADDRESS: |
| TIN: |
| ADDRESS 2: |
| PO CONTACT NAME: |
| PO CONTACT EMAIL: |
| PO PHONE #: |
| REMIT ADDRESS: |
| REMIT CONTACT NAME: |
| REMIT CONTACT EMAIL: |
| REMIT PHONE #: |
| Date14_af_date: |
| TITLE: |
| SIGNATURE: |
| PRINTED NAME: |
| REMIT ADDRESS 2: |
| REMIT CITY: |
| REMIT STATE: |
| REMIT ZIP: |
| PO CITY: |
| PO STATE: |
| PO ZIP: |
| YES OR NO: |
| SERVICE DESCRIPTION: |
| Yes Check: Off |
| Yes Same Info: Off |
| Yes ACH: Off |
| Yes or No: |
File details come from the government source that posted it. Updated .