VENDOR APPLICATION

VENDOR APPLICATION
General Services Department Support ServicesPurchasingDivision 675 Texas Street, Suite 2500, Fairfield, CA 94533-5801 Phone/Fax (707) 784-6320 / Email: Purchasing@solanocounty.gov
Please note, if you list only a P.O. Box, and/or your address is NOT in CA, a Non-Resident form will be required in addition to the application and W-9. (See Bottom of Application for Forms)*

New RequestChange / Update Information
TIN or SSN #
Date

MonthDayYear
Date
Name / Business Name / Doing Business as (DBA) (as listed on income tax return)
Business Address

Street Address

Suite # (if applicable):

CityState / Province

Postal / Zip Code
Phone Number
FAX Number(Optional)
Email AddressBusiness Email Preferred
example@example.com
Payment Information/Remittance

(Required if Different from Above)
7. Name/Business Name (Indicate the business name as it will appear on the invoice)
Payment Mailing Address

Street Address or P.O. Box

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
FAX Number
Email Address
example@example.com
Direct Deposit

Yes, I would like to request a Direct Deposit Form
CSLB Information - Click Here
Contractor’s License Number if ApplicableCSLB Information - Click Here
DIR Information - Click Here
Department of Industrial Relations (DIR) Number (Public Works Projects Only) DIR Information - Click Here
National Institute of Governmental Purchasing (NIGP) Code (Required). Click on the link below to select the code(s) which best describes the commodities and/or services associated with your business.
Click the "NIGP Codes" and select Categories to find the applicable code(s) for your business.

NIGP Codes

List of Service Types/Codes

	Commodity/Service Type	Code Number
1
2
3
4
5
6
7
8
9
10
11
12

Are you currently engaged with a County representative regarding your services?

YesNo
County Contact

First NameLast Name
Solano County Department*
The agency/department your contact is associated with.
Print Name
Title (optional)
Date

MonthDayYear

Click on applicable tax form(s) below to submit with application. All U.S.vendors are required to submit a W-9. Forvendors outside of the state of CA, a Non-Resident form is required by the CA Franchise Tax Board and must besubmitted with the application & W-9. For information regarding Non-Resident forms, please visit: https://www.ftb.ca.gov

W-9	Required for All U.S. Vendors
CA-587	Complete if CA-590 is not applicable and you DO Not have a physical or permanent place of business in CA
C-590	Complete if CA-587 is not applicable and you have a physical or permanent place of business in CA and/or are qualified to do business in CA
Non-Resident Certification	Out of CA Vendors complete if neither the CA-587 or CA-590 are applicable
W-8BEN	Individuals Outside of the U.S.
W-8BEN-E	Entities Outside of the U.S.

Attach Additional Forms

Cancelof
Should be Empty:

VENDOR APPLICATION

Payment Information/Remittance