City of Delray Beach. Vendors Form

ID and Commodities Offered
Federal Tax ID Number *
Commodities Offered *
Enter codes exactly as they appear on the Commodity Code List. Separate each code by a comma. (e.g. 5, 71, 100, 910)
Primary Business Information
Business Name *

Address *
City *
State *
Zip Code *

E-mail Address *
Phone Number *
Fax Number
Contact Type
Select at least one contact type *

Solicitation Information
Remittance
Purchase Orders

Note: to add additional business contacts, please use the Secondary Business Info and Tertiary Business Info sections. If there is another contact to whom the remittance payments and purchase orders should be sent to other than the contact listed in the Primary Business Information section above, please also list those contact(s) under the Secondary Business Info and Tertiary Business Info tabs and select the appropriate checkbox for those contacts i.e. Solicitation Information, Remittance, Purchase Orders.

Secondary Business Information

Business Name

Address
City
State
Zip Code

E-mail Address
Phone Number
Fax Number
Contact Type
Solicitation Information
Remittance
Purchase Orders

Tertiary Business Information
Business Name

Address
City
State
Zip Code

E-mail Address
Phone Number
Fax Number
Contact Type
Solicitation Information
Remittance
Purchase Orders

Please Review and Submit
Please review the information entered in the previous sections before you submit the form. Once submitted you won't be able to modify it



* denotes required field