Vendor_Information_-_rev_11.8.24_(FILLABLE)_(2).pdf

2 MB Posted

Attached to
Tourism Sustainability Master Plan
Solicitation number
25-RFP-077
Issued by
Glades County, Brownsville CDP, Florida

About this file

Written by GovTribe AI ·

The document is a Vendor Information Form from the Flagler County Board of County Commissioners Purchasing Department. The form is designed to collect comprehensive details about potential vendors seeking to do business with Flagler County, Florida. It provides a structured template for businesses or individuals to submit their contact information, tax identification, business classification, and administrative details.

The form allows vendors to indicate special business classifications such as local vendor preference or women/minority business enterprise status, and requires vendors to specify whether they provide technology services. Additional administrative requirements include attaching a Certificate of Insurance and a W9 form, and indicating willingness to accept credit card payments. The form is intended to standardize vendor registration and provide the Purchasing Department with essential information for vendor qualification and record-keeping purposes.

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Name of Business Entity or Individual:

Doing Business As (DBA) Name; Registered Fictitious, Trade or Assumed:

Tax ID Number: FEIN SSN/ITIN OTHER

Website:

Company/Corporate Address:

Address:

City:

State: Zip:

Phone: Email:

Payment Address (if different from above):

Address:

City:

State: Zip:

Vendor No: Input by:

PURCHASING USE ONLY

FLAGLER COUNTY

BOARD OF COUNTY COMMISSIONERS

PURCHASING DEPARTMENT

VENDOR INFORMATION FORM

Accept Credit Card? Yes _____ No _____

Check any special business classifications that apply to your business. Classifications are subject to approval.

_____ Local Vendor Preference

_____ Women/Minority Business Enterprise

Is Vendor providing a technology (IT) service? Yes _____ No _____

Certificate of Insurance attached? Yes _____ No _____

W9 attached? Yes _____ No _____

Sheet2

Name of Business Entity or Individual:
Doing Business As DBA Name Registered Fictitious Trade or Assumed:
Tax ID Number:
Website:
Address:
City:
State:
Zip:
Phone:
Fax:
Payment Address:
Payment City:
Payment State:
Payment Zip:
Tax Type: Choice1
Yes - Accept Credit Card: Off
No - Do not accept credit cards: Off
Local Vendor Preference: Off
Women/Minority Business Enterprise: Off
Yes, COI Attached: Off
No, COI not attached: Off
Yes, W9 attached: Off
No, W9 not attached: Off
Yes: Off
No: Off

File details come from the government source that posted it. Updated .