Vendor Information Form

2. Department or Individual Submitting Request

4. Company

6. Company Address

8. City

9. State

10. Zip Code

12. Phone Number

13. Fax Number

15. Contact Person

16. Email Address

18. Federal Tax ID Number (Business)

20. Contractor License Number (if applicable)

22. Type of Organization

    1. Corporation
    2. Individual
    3. Partnership
    4. Other

23. If the type of organization is other, please explain.

27. Officers, Owners, or Partners

29. President

30. Vice President

32. Secretary

33. Treasurer

34. Owners/Partners

36. Type of Business

    1. Manufacturer
    2. Construction
    3. Registered Dealer
    4. Surplus Dealer

    1. Service Establishment
    2. Architect/Engineer
    3. Other

37. If the type of business is other, please explain.

39. Products and/or Services Offered (additional information may be attached)

40. Additional Resources

42. Indicate types of requests your company would like to be informed of (check all that apply)

    1. Low-value purchases (less than $500)
    2. Informal bids (less than $30,000)
    3. Formal bids ($30,000 and above)
    4. Construction projects
    5. Requests for proposals

43. Please upload a copy of your IRS Form W-9

45. If Printing and Returning by Mail:
    Please return this form and IRS Form W-9 to: <br>Rowan County Finance Department<br> Attn: Purchasing Agent<br> 130 W Innes Street<br> Salisbury, NC 28144<br>

    Please return this form and IRS Form W-9 to:
    Rowan County Finance Department
    Attn: Purchasing Agent
    130 W Innes Street
    Salisbury, NC 28144
    

Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

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