Vendor_Information_-_rev_11.8.24_(FILLABLE).pdf

PDF 2 MB Posted

Attached to
Tourism Website Design, Development & Maintenance
Solicitation number
26-RFP-003
Issued by
Glades County, Brownsville CDP, Florida

About this file

This is a Vendor Information Form submitted to the Flagler County Board of County Commissioners Purchasing Department in Florida for the Tourism Website Design, Development & Maintenance contract opportunity. The form is a standardized template designed to collect essential vendor credentials and business information from firms interested in providing website design and development services to Flagler County. The document requests completion of standard business registration details including the legal name of the business entity, doing business as (DBA) names, tax identification numbers, and contact information including company address, phone, email, and payment address if different from the primary location.

The form includes checkboxes for vendors to indicate special business classifications such as local vendor preference and Women/Minority Business Enterprise status, as well as confirmation of technology service provision related to information technology. Additionally, the form requires vendors to confirm submission of supporting documentation including certificates of insurance and completed W-9 tax forms, and to specify payment method preferences regarding credit card acceptance. The document is fillable in digital format and includes fields designated for purchasing department use only, such as vendor number assignment and data entry personnel identification.

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Text version

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 .