City of Oakwood
NEW VENDOR INFORMATION REQUEST
Vendor Number:
This area is for office use only.
Please fill out all information that applies to you or your business.
Return the completed form to the person you are working with at the City of Oakwood or send completed form and W-9 to accountspayable@oakwoodohio.gov to be added to our vendor listing.
Ordering Address/Information
Company/Individual Name
(As shown on Income Tax Return)
DBA Name
(If applicable)
Address
City
State
Zip
Phone No.
Fax No.
Email address
Remit to Address (If different from above)
Address
City
State
Zip
Accounts Payable Contact
Name
Phone No.
Email address
Payment Information - Payments issued by the City of Oakwood are via Corpay, a third party A/P Automation service. The vendor is responsible for setting up payment details in Corpay.
Commodities or Services you are interested in supplying:
Merchandise - List Type of Merchandise
Services - List Type of Services
Does any owner, officer, employee, or shareholder of this company have any known relationship with the City of Oakwood, its employees or any members of their families?
Yes
No - If yes, explain:
I certify that:
- I am, or this business is, legally authorized to do business in the State of Ohio.
- I understand that the City of Oakwood does not accept any vendor processing fees.
- I understand that the City of Oakwooed is a tax-exempt political subdivision of the State of Ohio.
Certification - Sign and Date New Vendor Information Request
Printed Name & Title:
Signature:
Print & Sign (Signature required)
Date:
(MM/DD/YYYY)
City Contact Person:
NAME
Fax or email