Vendor Registration Form.pdf
PDF 434 KB Posted
- Attached to
- Nursing Products
- Solicitation number
- 052522NP
- Issued by
- Travis County, Texas
About this file
The document is a Vendor Registration Form for Southwest Key Programs, a Texas-based organization seeking to procure nursing products for multiple facilities. The form is designed to collect comprehensive vendor information, including contact details, business classification, insurance status, and company background. Vendors are required to submit a completed W-9, current Certificate of Insurance, and additional documentation about their organization, including basic organizational information, office locations, and a list of similar customers and projects.
The registration form allows vendors to self-identify as women-owned, minority-owned, small business, or veteran-owned businesses, which may provide potential competitive advantages in the bidding process. Key documentation requirements include providing an Employee Identification Number (EIN), Texas Identification Number (if applicable), and Dun & Bradstreet Number. Vendors must indicate their insurance, bonding, and licensing status, and are expected to provide detailed information about their products, services, and organizational capabilities. The form is version 3.0, effective 6/22/2021, and was last revised on 04/20/2022, suggesting an ongoing effort to maintain current vendor information for the nursing products procurement.
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Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT C - Bid Price Sheet.xlsx | XLSX spreadsheet | |
| IFB 052522NP Nursing Products.pdf |
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Text version
Vendor Registration Form
Version 3.0 Effective: 6/22/2021 Revised: 04/20/2022
Date:
Contact Information:
Contact Name: Contact Email:
Company Name:
Address:
City, State, Zip:
Phone
Fax:
Employee Identification Number (EIN):
Texas Identification Number, if applicable
Dun & Bradstreet Number, if applicable
Type of Business:
Products:
Services:
Is Your Company…
Insured? ☐ Yes ☐ No Bonded? ☐ Yes ☐ No
Licensed? ☐ Yes ☐ No License Number:
Women Owned: ☐ Small Business:
☐ Minority Owned: ☐ Veteran Owned: ☐
Additional Comments:
Required Documents:
• Completed W-9, Request for Taxpayer Identification Number and Certification
• Current Certificate of Insurance
• Provide the following information in a written document:
o Basic organizational information (size of organization, how long in business, public or private entity, etc.).
o List of office location(s).
o List of similar customers and projects.
Email the completed form and required documents to:
File details come from the government source that posted it. Updated .