Office of Contracting & Procurement




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On-Line Vendor Registration Application

The information collected on this application is for the sole use of the Office of Contracting and Procurement and the Government of the District of Columbia. The submission of this form does not confer nor imply any commitment and/or obligation to either the company submitting the form or the Government of the District of Columbia and its representatives. View Definitions and Instructions.

VENDOR BUSINESS INFORMATION

Name of Business:         New Business
Fed. Tax No. (EIN)/Single Entity: Soc. Security No.: (9 digits)
* DUNS No.:(XX-XXX-XXXX)
Password (length: 4 ~ 8): Re-type the Password:
Address: (Street) (Street Name)

City: State/Country: Zip:
Telephone No.:(XXX-XXX-XXXX) Fax No.:(XXX-XXX-XXXX)
Web Address: Email Address:

VENDOR DEMOGRAPHICS

Not For Profit

Are you CBE certified?    CBE Certification No.:
Small Local Resident-Owned Enterprise Zone Disadvantaged Longtime Resident

Is your business based in DC? If so, which ward?

TYPE OF CONTRACT OF INTERESTS

Type of Contract of Interests: DCSS      HCA      IPT

VENDOR CONTACT INFORMATION
Billing and Contract Management Contact
(Same as Company Information - )

Name:
Phone No.:(XXX-XXX-XXXX)
Fax No.:(XXX-XXX-XXXX)
Email Address:

Address to which Solicitations Should Be Mailed:
(Same as Company Information - )

Mailing Name:
Address: (Street) (Street Name)
City: State/Country: Zip:

VENDOR SERVICES INFORMATION
Offering
Goods Personal/Professional Services Non-Professional Services
Construction:
Heavy (Street/Highways) Building (General) Specialty Trades
Other:

What Size Contracts Are You Interested In Bidding On?
Small ($100,000 and Under) Large (Over $100,000) Both

Are you Capable of Accepting the Government Credit Card? (i.e., Visa)
Yes No
NIGP Code(s) That Describe Your Company's Offering(s)
(Please choose no more than 5 NIGP codes)

Please click on the NIGP Codes button to insert your NIGP codes. To clear the inserted code(s), please click on the corresponding box(es).
1.     2.     3.     4.     5.


* If your company does not at present have a DUNS No., please contact Dun & Bradstreet at 1-800-234-3867 for information on how to obtain a DUNS number, free of charge. If your company is a new start-up business please check the box marked 'New Business'. However, a DUNS number will be required prior to the award and execution of a contract. All fields should be completed. Fields marked in blue are optional. If you have any questions about filling in this form, please refer back to the instructions.