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Procurement Services Vendor Application
 

Please complete the following information answering all questions where applicable. 
To ensure the accuracy of your listing, please carefully check the information prior to submitting.
 
Company Name:
Your Name:
Title:
Address:
City:
State:
Zip Code:
Phone:
Toll-free:
Fax:
Email Address :
Website (URL) :
Solicitation Number :
Years Established :
Business Activity :
   
No. Of Employees:
 
Business Enterprise : (Check all that apply)
Small Woman-Owned Minority Other
   
Person Completing Form:
   
Please list below the type of equipment, supplies, material, and/or services you furnish.  The greater the detail you can give on your product lines, the more complete your registration will be and the more likely you will receive bid request for all your products which the District Uses.
   

APPLICANT'S CERTIFICATION: 

The person below certifies that information supplied herein is correct and neither the applicant nor any person in any connecting with the applicant as a principal or officer, so far as is known, now debarred, suspended or otherwise declared ineligible by any agency of the Federal Government , agencies of the State of South Carolina or by Richland County School District One.
 
Person Authorized to sign this application (Type in name):
Title:
Date:
FEIN or SSN: