17300.docx
DOCX document 262 KB Posted
- Attached to
- LEGAL SERVICES - TVA
- Solicitation number
- TVA-062016-OGC
- Issued by
-
Tennessee Valley Authority
About this file
Supplier Information Form required on Page 11 Attachment 3 of RFP package.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFP_questions_responses.pdf | ||
| RFP_questions_July_6 _2016.pdf | ||
| TVA_Legal_Services_RFP_6-24-2016.pdf |
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Text version
Business Information Company Name:
Tax Payer ID (Required):
Street Address:
County:
City, State, Zip:
Telephone:
Fax Number:
Contact Name:
Email address:
Please provide a completed W-9 form For your convenience a link to a blank W-9 is attached to this form.
| Has your company ever been known by another name? | Yes |_| No |_| |
| If yes, please provide former names below: |
| Are you incorporated? | Yes |_| No |_| |
| If yes, please provide state you are incorporated in. |
| Doing Business As (DBA)? |
| Will you be receiving orders via EDI? | Yes |_| No |_| |
| **If ‘Yes’, Please supply your EDI ID, contact name, and phone number: |
| Will you be receiving orders via email? | Yes |_| No |_| |
| ** If ‘Yes’, please provide the email address to be used and name of contact: |
Business Classification COMPANY CLASSIFICATION: (Choose One)
| |_| |
| Small Disadvantaged Business* |
| |_| |
| State/Local Government-Educational |
| |_| |
| Small Business |
| |_| |
| State/Local Government-Hospital |
| |_| |
| Other Small Business** |
| |_| |
| Other State/Local Government |
| |_| |
| Large Business |
| |_| |
| Foreign Contractor |
| |_| |
| JWOD Nonprofit Agency*** |
| |_| |
| Domestic Contractor Performing Outside U.S. |
| |_| |
| Nonprofit Education Organization |
| |_| |
| Federal Agency (if yes, provide FEDA CODE ________. See FEDA CODE chart below) |
| |_| |
| Nonprofit Hospital |
| |_| |
| Other Nonprofit Organization |
| |_| |
| Historically Black College/University or Minority Institution (HBCU/MI) |
TVA Vendor Information/ Electronic Payment Records
TVA 17300 [02-11-2014] Page 1 of 5
| * | A firm must be owned and controlled by one or more individuals who are socially and economically disadvantaged as defined in FAR 19.001. Includes Hub Zone small disadvantaged business concerns. |
| ** | Small business concern (including an individual) as defined in FAR 19.001 when Small Disadvantaged Business does not apply. Includes Hub Zone small business concerns. |
| *** | A non-profit agency employing people who are blind or severely disabled. |
DIVERSITY STATUS: (Check any that apply)
| |_| | Minority-Owned Business* |
| |_| | Veteran-owned Business* |
| |_| | Service Disabled Veteran-Owned Small Business |
| |_| | Qualified Hub Zone Small Business Concern |
| |_| | Qualified Hub Zone Small Business Concern/8A |
| |_| | Woman-owned Business* |
| |_| | 8(a) certified (as defined by SBA) |
| |_| | Mentoring Program Participant |
*Must be 51% owned, operated, and controlled.
| Are you MWBE certified? | Yes |_| No |_| |
| If yes, name of the certifying agency(s) |
Does your business have any relationship or affiliation with any TVA employee (s)? Yes |_| No |_| If yes, please provide the TVA employee(s) name and the nature of the relationship or affiliation.
Please provide your NAICS code________
(see http://www.census.gov/eos/www/naics/ for a listing of codes.)
Note—All vendors must notify TVA of changes to business information, classification and/or status.
VALLEY BUSINESS PRESENCE:
TVA considers a company as having a Valley business presence if one of the following criteria is met:
| (1) | a company that provides products, labor, and/or services through an operational business unit located in the Tennessee Valley region, or |
| (2) | Although headquartered outside the Valley, contributes to the economic development of the Valley by maintaining a meaningful presence by providing at least 60% of the TVA contract work requirements through the employment of personnel residing in the Valley. (See map attached) |
Please double-click on icon below for TVA Vendor Information Map.
Based on the above description, can your business be classified as Valley Business Presence? Yes |_| No |_| Hub Zone Code: Choose one if applicable. For an explanation of the Small Business Administration’s Hub Zone code and to readily determine if your company qualifies as a Hub Zone business, you may access information at http://www.sba.gov/hubzone. Mentored firms are TVA suppliers participating in the Procurement Mentoring Program.
Please double-click on icon below for W-9 –Request for Tax-payer Identification Number and Certification Form.
(Note: Complete this section only as requested by TVA) Vendor Payment Form Company/Vendor Information
| Name: |
| Taxpayer Identification Number: |
| Accts. Receivable Contact Name: |
| Phone #: |
| ( ) |
| Fax #: |
| ( ) |
Select one of the options below to receive your remittance information:
| |_| |
| Send remittance information to e-mail address |
| |_| |
| Send remittance information to bank with payment |
FINANCIAL INSTITUTION INFORMATION
| Bank Name: |
| Address: |
| Phone #: |
| ( ) |
| Nine-digit Routing Transit Number: (ACH) |
| Account Number: |
| Type of Account: |
| |_| Checking |
| |_| Savings |
For TVA Use Only
| Vendor Record No.: |
(Note: Complete this section only as requested by TVA) The following information should be supplied when a Contract Manager/Contract Agent receives information that a company name has changed.
| CM/CA Name: |
| CM/CA Phone No.: |
| Current Vendor Number(s): |
| Current Vendor Name: |
| Current Vendor Address: |
| New Vendor Name: |
| Effective Date of Name Change: |
| New Vendor Address: |
QUESTIONS TO BE ANSWERED BY THE VENDOR AND/OR THE BUYER:
Have you agreed to honor existing commitments under your former name?
(Explain if applicable.)
Yes |_| No |_|
Has some type of Master Assignment Agreement been issued?
(Explain if applicable.)
Yes |_| No |_|
Will each affected buyer be required to issue an assignment agreement for unfilled requirements?
(Explain if applicable.)
Yes |_| No |_|
| If a new vendor number is issued, will the buyer be required to issue revisions on all outstanding POs and/or releases? |
| Yes |_| No |_| |
Did the TAX ID, phone, fax, email, etc., change? (Include any changes in section for this information.)
(Explain if applicable.)
Yes |_| No |_|
| Is the vendor a manufacturer with CAT IDs? |
| Yes |_| No |_| |
Will the banking information change?
(If yes, fill out information in section for Electronic Vendor Payment Information.)
Yes |_| No |_|
| CHECKLIST |
| Outcome |
| CM/CAs |
| Vendor and/or CM/CA answer questions pertaining to the name change and complete appropriate section if other categories have changed and, if the banking information will change complete section for Electronic Vendor Payment Information. |
| Check Maximo to see who the other buyers are with open contracts with the vendor and email the buyers to notify them of your plan to request a name change on vendor number ______ and copy Supplier Information (Vendor Control) on the email. |
| Review for completeness and Email form 17300 to Supplier Information mailbox or FAX to 751-2914. If the banking information is not changing, specifically notify Vendor Control when sending the request for a name change. |
| Vendor Control |
| Request input from all of the Vendor Control Group by routing information electronically. Routing list will include Delores Readus for EDI, Accounts Payable, Accounting Services, Classification, Vendor Audit Services (if ASL “Y” or “I”). Indicate “Yes” or “No” changing banks. |
| Research Maximo to make changes to applicable vendor nos. Notify any CM/CAs who have open contracts with the vendor but were not notified in the email from the CM/CA requesting the change and copy the requester and other CM/CAs who had been notified by the requester. |
| Key information into the NOTES panel (old vendor name, old vendor address, effective date of name change, CM/CA requesting change, other CM/CAs notified, all affected vendor numbers, etc.). |
| Notify Vendor Control Group and Procurement of changes. Give a short description of the change(s) made and the reason(s) change(s) were made, including the effective date of change. |
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FEDA CODES.pdf
FEDA CODES
1000 The Judiciary 6200 Office of Special Counsel
1100 Executive Office of the President 6300 National Labor Relations Board
1200 Department of Agriculture 6400 Tennessee Valley Authority
1300 Department of Commerce 6500 Federal Maritime Commission
1400 Department of Interior 6800 Environmental Protection Agency
1500 Department of Justice 6900 Department of Transportation
1601 Department of Labor 6903 St. Lawrence Seaway Development Corporation
1602 Pension Benefit Guaranty Corporation 7000 Department of Homeland Security
1700 Department of Navy 7100 Overseas Private Investment Corporation
1800 U.S. Postal Service 7200 Agency of International Development
1900 Department of State 7300 Small Business Administration
2 000 Department of Treasury 7400 American Battle Monuments Commission
2100 Department of Navy 7500 Department of Health and Human Service
2300 U.S. Tax Court 7601 Historical and Memorial Commission
2400 Office of Personnel Management 7802 Farm Credit System Insurance Corporation
2500 National Credit Union Administration 7801 Farm Credit Administration
2600 Federal Retirement Thrift Investment Board 8800 National Aeronautics and Space Administration
2700 Federal Communications Commission 8300 Export-Import Bank of the United States
2800 Social Security Administration 8400 Armed Forces Retirement Home
2900 Federal Trade Commission 8600 Department of Housing and Urban Development
3100 U.S. Nuclear Regulatory Commission 8800 National Archives and Records Administration
3300 Smithsonian Institution 8900 Department of Energy
3301 JFK Center For Performing Arts 9000 Selective Service System
3302 National Gallery of Art 9100 Department of Education
3303 Woodrow Wilson International Center for Scholars 9108 Appalachian Regional Development Test
3400 International Trade Commission 9300 Federal Mediation and Conciliation Service
3600 Department of Veteran Affairs 9500 Independent Agencies
4100 Merit Systems Protection Board 9600 U.S. Army Corps of Engineers
4500 U.S. Equal Employment Opportunity Commission 9700 Office of the Secretary of Defense-Defense Agencies
4600 Appalachian Regional Commission 9900 Treasury General Fund
4700 General Services Administration 9999 Unidentified
4800 Temporary Commissions 0100 Architect of the Capitol
4900 National Science Foundation 0200 U.S. Capitol Police
5000 Securities and Exchange Commission 0300 Library of Congress
5100 Federal Deposit Insurance Corporation 0400 Government Printing Office
5400 Federal Labor Relations Authority 0500 Government Accountability Office
5600 Central Intelligence Agency 0800 Congressional Budget Office
5700 Department of the Air Force 0900 Other Legislative Branch Agencies
5900 National Foundation of the Arts and the Humanities
6000 Railroad Retirement Board
6002 National Railroad Retirement Investment Trust
6100 Consumer Product Safety Commission image2.wmf oleObject2.bin image3.wmf oleObject3.bin
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