W-9 Form - UB Substitute48.pdf
IRS Form PDF 368 KB Posted
- Solicitation number
- 2062576
About this file
This document is a W-9 Form and Vendor Information Form for a state and local contract opportunity in New York. The contract opportunity is for Interior Painting Services at multiple residential and program sites in Cattaraugus, Chautauqua, Erie, Genesee, Niagara, and Orleans counties from 2020-2025. The Western DDSOO is soliciting sealed bids from responsible and qualified contractors. References, experience, financial resources, and applicable insurances are required. The contract will be awarded to the most responsible and responsive bidders that provide the lowest Total Annual Estimated Combined Cost per County. Prevailing Wage will apply.
The contract opportunity has a Minority Owned Sub-Contracting Goal of 17% and a Women Owned Sub-Contracting Goal of 13%. It is not a Service-Disabled Veteran-Owned Set Aside. The due date for responses is 03/11/2020 at 2:00 PM.
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Who attaches IRS Form W-9
| State | Files |
|---|---|
| Massachusetts | 7,066 |
| Colorado | 1,101 |
| Texas | 1,097 |
| New York | 906 |
| Florida | 625 |
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Text version
Rev 12/2018
Choose one
Check all that apply
Complete all fields
Complete all fields VENDOR INFORMATION: Phone # Fax # NY State Vendor ID#
DUNS # Website
Order Address
Order Email address
Remittance Address
CONTACT INFORMATION: Name Email Phone (Individual authorized to represent the vendor and to maintain data housed in the NYS vendor database if edits to information are necessary i.e. change of address, etc.)
BUSINESS TYPE: Large (over 500 employees) Small (under 500 employees) Not-for-Profit Individual
CLASSIFICATION:
Woman-owned Veteran-owned State Preferred Source
NYS Certified Woman-owned Service Disabled Veteran-owned Disadvantaged
Minority-owned NYS Certified Service Disabled Veteran-owned HUB Zone
NYS Certified Minority-owned Historically Black College/University or Minority Institution
Substitute W-9 and Vendor Information Form We require completion of both the upper & lower portion of this document in its entirety.
Return to the requester indicated in the W-9 portion below.
| DBA: |
| Other: |
| Address: |
| City, State, Zip: |
| Acct Numbers: |
| Name: |
| Tax Class: |
| Exempt Payee Code: |
| Exempt FATCA Code: |
| SS#1: |
| SS#2: |
| SS#3: |
| EIN#1: |
| EIN#2: |
| Phone#: |
| Fax#: |
| NYS Vendor ID#: |
| DUNS#: |
| Website: |
| PO Address: |
| PO Email Address: |
| Payment Address: |
| Contact Name: |
| Contact Email: |
| Contact Phone#: |
| Business Type: Choice4 |
| Class-NYS Cert SDVO: Off |
| Class-W/O: Off |
| Class-NYS Cert W/O: Off |
| Class-M/O: Off |
| Class-NYS Cert M/O: Off |
| Class-V/O: Off |
| Class-SDVO: Off |
| Class-Hist Blk Col Univ MI: Off |
| Class-NYS Pref Src: Off |
| Class-Disadvantaged: Off |
| Class-HubZ: Off |
| Fed Tax Class: Choice4 |
| Date: |
| Requester's Name & Email Adrs: [.] |
| Requester's Physical Address: Procurement Services / 224 Crofts Hall / Buffalo NY 14260 |
| Requester's Fax #: Fax #716-645-2687 |
File details come from the government source that posted it. Updated .