Vendor_Information_-_rev_11.8.24_(FILLABLE).pdf
PDF 2 MB Posted
- 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 .