Vendor/Bidder Application

Description

Vendor Application - Businesses ☐ New Vendor ☐ Updated Vendor Info University Use Only Vendor #: Entered By: New Vendor Applications Only: This form must be submitted along with a completed IRS W-9/W-8. If a completed W9/W8 is not received with this application, your application will not be accepted. Applications are taken by eMail Only. Email completed applications to: wmu-purchasing@wmich.edu Western Michigan University – Logistical Services 1903 W Michigan Ave Kalamazoo, MI 49008 I Phone: (269) 387-8800 Vendor’s Representative Signature: Date: Printed Name: Title: Phone: Fax: Company Name & Bid Address Accounts Receivable / Remit To Address: ☐ Same as mailing address Telephone Telephone (Toll Free) Contact Name Contact Email: Website Generic BID/PO Email: Fed. Id. No. (FEIN) SSN (if no FEIN) Number of Employees: Date Established: Type of Business (check all that apply) ☐ Manufacturer or Producer ☐ Dealer ☐ Wholesaler ☐ Broker ☐ General Contractor ☐ Retailer Sub-Contractor ☐ ☐ Other Number of Employees Type of Organization (check all that apply) Corporation Date Incorporated State Non-Profit Sole Proprietor Partnership - LLC ☐ PSC Other (Specify) ☐ ☐ ☐ ☐ ☐ ☐E&I ☐GSA ☐HPS ☐MiDeal Consortium Contract ☐MHEC ☐National IPA ☐Sourcewell ☐U.S. Communities Gov. Purchasing Alliance Conflict of Interest ☐ Yes ☐ No Are you or any Officer, Owner or Partner in this company an employee of Western Michigan University, or have you been an employee within the past 24 months? ☐ Yes ☐ No Are any immediate family members of any Officer, Owner or Partner in this company employees of Western Michigan University? If yes to either above, please state who and explain and their University position or the family relationship (father, mother, sister, brother, child, etc.): 1. 2. 3. References ACH Information Bank Name Bank Address Account Type Checking Routing Number Account Number Remittance Email Address Savings Important Vendor information regarding our ACH process: Please be advised that there are occasions when your company may issue a credit memo to Western Michigan University. In order for the system to work properly please make sure that your bank account is able to accept both credit and debit ACH transactions (we would never send a debit without a credit). If your company or bank does not allow/want debits (credit memos) transmitted via ACH please indicate that you are not interested at this time.