Required Vendor Application Form.pdf
PDF 63 KB Posted
- Solicitation number
- 36052
- Issued by
- New Haven County, Connecticut
About this file
This is a Vendor Application Form issued by the Borough of Naugatuck, Connecticut for the procurement of portable toilet rental services under Contract No. FY27-B127. The Request for Proposal was released on April 10, 2026, with proposals due on April 28, 2026, at 11:00 AM EDT. The solicitation does not specify quantities, delivery terms, site visit requirements, or a bidders' conference. No estimated total contract value, contract term length, renewal options, or award date is provided in the available documentation. Vendors are responsible for determining their own pricing and payment terms as integral components of their proposals. Inquiries should be directed to Jennifer Scully, Purchasing Agent, at 203-720-7025 or jscully@naugatuck-ct.gov.
The application form requires vendors to provide comprehensive business information including W-9 tax documentation, proof of any required state licenses specific to the work performed, and a Certificate of Insurance (COI) along with a signed Insurance Agreement. The form accommodates various business entity types including C Corporations, S Corporations, sole proprietors, single-member LLCs, partnerships, trusts, and estates. No set-asides, disadvantaged enterprise designations, incumbent vendor information, or restrictions on organization types are identified in the solicitation materials. Vendors must indicate whether services will be performed at borough property or at the vendor's location and declare whether Connecticut state licensure is required for the work. The solicitation materials do not specify contract funding sources, amounts, or other financial requirements beyond standard vendor compliance documentation.
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Other files
| File | Type | Posted |
|---|---|---|
| 36052_May_4_26_solicitation_doc.pdf | ||
| 36052_Apr_27_26_solicitation_doc.pdf | ||
| 36052_Apr_15_26_solicitation_doc.pdf | ||
| VendorChangeDetailsReport_36052_v1_Apr_15_26.pdf | ||
| FY27-B127 Rental of Portable Toilets.docx | DOCX document | |
| Addendum 1-4.14.2026.pdf |
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Text version
VENDOR INFORMATION
PO MAILING ADDRESS if different from above
POINT OF CONTACT FOR SALES - NAME & TITLE POC EMAIL
ORGANIZATION TYPE (Please submit completed W9)
VENDOR TYPE
SERVICE Type of Service
PRODUCT Type of Product
BOTH
SERVICE VENDORS
Where will the Service be performed: Borough Property Vendor's location
Is a State Licens Required to perfom work in the State of Connecticut? YES NO If Yes:
Credential Number (also provide a copy of current license) **Also provide individual license copy for employees performing work onsite(i.e. Electrical license, HVAC, etc)
NOTE: Service Vendors require a COI to be sumitted to Purchasing, as well as a signed Insurance Agreement
DEPARMENT USE ONLY
Expected Annual Purchase $$
Anticipated Purchase Authority (reason for adding vendor)
Which line item from your GL will this Vendor fall under?
Will we be processing payments for this Vendor? YES NO
Documents obtained: W9 COI Signed Insurance Agreement
VENDOR ID. If applicable
TAX ID NUMBER FEIN OR SSN
COMPANY / FIRM NAME as shown on Federal Tax Return
ALTERNATE NAME if applicable/(doing business as)
VENDOR ADDRESS
PAYMENT ADDRESS if different from above
PHONE
Limited Liability Company. (C=Corp, S=S Corp, P=Partnership
Trust/estate
Other
FAX WEBSITE
VENDOR APPLICATION FORM
BOROUGH OF NAUGATUCK
229 Church Street
Naugatuck, CT 06770
Type of License for Business: (Electrical, Mechanical, HVAC, etc.)
C Corporation
S Corporation
Individual/Sole Proprietor or Single Member LLC
Partnership
File details come from the government source that posted it. Updated .