Template_-_New_Vendor_-_Modify_Request_Form.pdf
PDF 1 MB Posted
- Solicitation number
- QQ-2026-097
- Issued by
- Collier County, Florida
About this file
This is a New Vendor/Modify Request Form template issued by Collier County, Florida, designed to streamline the vendor registration and management process for county procurement. The form requires vendors to submit either new vendor applications or modification requests for existing vendor information, with completion and authorized signatures from the requesting vendor. New vendor submissions must include supporting documentation such as completed W-9 forms, IRS 501(c)(3) certification for nonprofit vendors, SunBiz registration confirmations, state registrations for out-of-state companies, Collier County tax receipts for local businesses, and E-Verify Memoranda of Understanding or company profiles. Modification requests for existing vendors require updated W-9 forms, current SunBiz registration confirmations with officer information, and E-Verify documentation. The form categorizes new vendors into five types: General Vendor (EIN reporting), Land, Non-Profit, Standard 1099 (Social Security number reporting), and Law Firm. Vendors can request changes to principal order addresses, remit addresses, company officers, email addresses, business phones, corporate status or name changes, and TIN/EIN numbers. The Collier County Division responsible for the vendor must verify form accuracy, confirm all supporting documentation is included, review existing vendor records in the SAP system, and submit complete packets to the Procurement Services Division, with incomplete submissions subject to rejection. Modifications to banking details and ACH information are not processed through this form and must be directed to the Clerk of Court Finance team at payops@collierclerk.com.
In relation to the Emergency Management Exercise Development/Evaluation consulting services solicitation, interested vendors must comply with these vendor registration requirements before submitting quotes. The consulting contract, estimated below $200,000 based on the absence of performance and payment bond requirements, does not impose set-aside designations for disadvantaged enterprises. No incumbent vendor has been identified for this one-time engagement. Contractors must maintain professional liability insurance of $1,000,000 per claim and aggregate, Commercial General Liability coverage of $1,000,000 per occurrence and $2,000,000 aggregate, Workers' Compensation at Florida statutory limits, and Employer's Liability of $500,000, with Collier County named as additional insured. Quote responses are due February 6, 2026, at 3:00 p.m. through Collier County's e-Procurement Portal, with award made to the responsive vendor submitting the lowest quote.
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Text version
NEW VENDOR / MODIFY REQUEST FORM Page 1 of 2 Revised 11/2025
NEW VENDOR / MODIFY REQUEST FORM
Note: This form must be completed by the reques�ng vendor and signed by authorized personnel. The required suppor�ng documents along with this form must be provided to the responsible Collier County Division representa�ve.
Instruc�ons For Vendor The following documents are required and must be atached separately:
Adding a new vendor Change to an exis�ng vendor o Completed W-9 o IRS 501 (C)(3) for non-profit vendor o SunBiz registra�on confirma�on printout or State registration (out of FL companies), showing the company is currently ac�ve (including officer informa�on) o SunBiz registra�on confirma�on printout for Fic��ous Name confirming/showing the company is currently ac�ve o Collier County Tax Receipt (if physical address is within Collier County) o E-Verify Memorandum of Understanding or Company Profile (e-verify.gov) o Completed W-9 o SunBiz registra�on confirma�on printout confirming/showing the company is currently ac�ve (including officer informa�on) o E-Verify Memorandum of Understanding or Company Profile (e-verify.gov) o If either the W-9 or E-Verify is under a parent or affiliated company name, a letter from the parent company explaining the rela�onship is required
Instruc�ons For Division The following steps must be completed by the responsible Collier County Division:
Step 1: Review the completed request form by the vendor for accuracy, and digital signature(s)
Step 2: Verify all the required suppor�ng documenta�on are included
Step 3: Review SAP for vendor record
For new vendors, confirm an account does not exist For changes, confirm an update was not already made and add the SAP# to the form
Step 4: Submit to Procurement
The Division requester is responsible for reviewing all documenta�on before submi�ng the packet to the Procurement Services Division. Incomplete packets will be rejected.
Modifica�ons to banking details (ACH) will NOT be accepted using this form.
Please contact the Clerk of Court Finance team at payops@collierclerk.com.
https://sp16.bcc.colliergov.net/sites/procurement/SitePages/Home.aspx mailto:payops@collierclerk.com
NEW VENDOR / MODIFY REQUEST FORM Page 2 of 2 Revised 11/2025
SECTION ONE: REQUEST TYPE (Select One)
Adding a new vendor (iden�fy primary use):
General Vendor (EIN# Repor�ng) Land Non-Profit Standard – 1099 (SS# Repor�ng)
Law Firm
Change to an exis�ng vendor (iden�fy type of change):
Principal Order Address Remit Address Company Officer Email Address
Business Phone Corporate Status or Name Change (Inc., LLC, etc.)
TIN/EIN Number
SECTION TWO: VENDOR INFORMATION
Legal Vendor Name
Principal Order Informa�on:
Address City State Zip Code Phone Fax Email
Remit Informa�on (if the informa�on is the same as the Principal Order, skip the address fields below):
Address City State Zip Code Phone Fax Email
Officer of the Company:
Name Title
Signature
TO BE COMPLETED BY THE RESPONSIBLE COLLIER COUNTY DIVISION
If this is a new vendor request, is the vendor related to a Solicita�on, Contract, Waiver, Exemp�on, Piggyback, or Non-Standard Contract?
Yes No Bid/Contract Number:
Exis�ng vendor SAP Number:
SECTION THREE: DIVISION REQUESTER INFORMATION
Name Telephone Number
Email Division
The requester acknowledges that the vendor informa�on provided has been verified and confirmed with the company’s officer.
Verified by Signature
| Request Type: Off |
| Corporate Status or Name Change (Inc: |
| , LLC, etc: |
| ): Off |
| Principal Order Information - Address: |
| Principal Order Information - City: |
| Principal Order Information - Phone: |
| Principal Order Information - Fax: |
| Principal Order Information - Email: |
| Principal Order Information - State: |
| Principal Order Information - Zip Code: |
| New Vendor Request Relation: Off |
| General Vendor (EIN# Reporting): Off |
| Land: Off |
| Non-Profit: Off |
| Standard - 1099 (SS# Reporting): Off |
| Law Firm: Off |
| Principal Order Address: Off |
| Remit Address: Off |
| Company Officer: Off |
| Email Address: Off |
| Business Phone: Off |
| TIN/EIN Number: Off |
| Legal Vendor Name: |
| Remit Information - Address: |
| Remit Information - City: |
| Remit Information - State: |
| Remit Information - Zip Code: |
| Remit Information - Phone: |
| Remit Information - Fax: |
| Remit Information - Email: |
| Officer of the Company - Name: |
| Officer of the Company Title: |
| Bid/Contract Number: |
| Existing vendor SAP Number: |
| Division Requester Name: |
| Division Requester Telephone Number: |
| Division Requester Email: |
| Division Requester Division: |
| Division Requester Verification: |
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