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Contact Information

To receive more information about purchasing, please contact:

Velicia Gaddy
Purchasing Support Specialist
(336) 370-3242

Vendor Application FIN-F043 Rev.10-22-04

Federal ID #:		SS#:
Vendor Name:

Federal ID# or SS# must be provided before payment can be made.

Order Address		Pay Address
Street:		Street:
City:		City:
State:		State:
Zip Code:		Zip Code:
Email Address:
Contact Person:		Telephone:
Fax:		Year Established:
Terms:		Discount:
Contractors License Number (if applicable):
Are you incorporated: yes

This firm certifies that it is a: (if applicable)
Women Business Enterprise: or
Minority Business Enterprise: or
Disabled Business:

To qualify for M/WBE status, 51 percent of the company must be owned and controlled by minority groups or women. For the purpose of this definition, minority group members are African Americans, Hispanic Americans, Native Americans, Asian Pacific or Asian Indians and American Women.

To qualify for Disabled status, 51 percent of the company must be owned and controlled by disabled persons.

Product(s) and/or Service(s)

Please list the type of product(s) and/or service(s) that your company can provide.

Customer Business References

1. Customer Name:
Address:
Contact Person:
Telephone Number:
Product/Service provided:
Date Product/Service provided:

2. Customer Name:
Address:
Contact Person:
Telephone Number:
Product/Service provided:
Date Product/Service provided:

3. Customer Name:
Address:
Contact Person:
Telephone Number:
Product/Service provided:
Date Product/Service provided:

In compliance with federal laws, Guilford County Schools administers all educational programs, employment activities and admissions without discrimination because of race, religion, national or ethnic origin, color, age, military service, disability or gender, except where exemption is appropriate and allowed by law. Refer to the Board of Education's Discrimination Free Environment Policy AC for a complete statement. Inquiries or complaints should be directed to the Guilford County Schools Compliance Officer, 120 Franklin Boulevard, Greensboro, NC 27401; 336.370.2323.

All Guilford County Schools facilities, both educational and athletic, are tobacco-free learning environments.