Supplier Information Form - TID Water & Power

Required fields are marked with an *

Supplier Name*

Address*

Phone Number*

Please enter your Phone Number in the following format: (###) ###-####

Website

Contact Person

Contact Person's Email Address

Please enter your Email in the following format: johndoe@email.com

Contact Person's Phone

Please enter your Phone Number in the following format: (###) ###-####

Contact Person's Mobile Phone (if available)

Please enter your Phone Number in the following format: (###) ###-####

Ownership of Business

Tell us about the ownership structure, tax information, payment terms etc,

Ownership Status*

State of Corporation

In which state is your business incorporated?

Payment Terms*

What terms, if any do you offer your customers?

Shipping Terms*

Number of Years in Business*

How long has your company been in business?

Number of Employees*

How many employees does your company have?

If you're from out of California, do you collect California State Sales Tax?*

Yes
No

Do you have online order tracking capability?

Yes
No

Is your catalog, line card or price list attached? (Select "Yes" to attach it)

Yes
No

Attach catalog, line card or price list. (multiple files OK)

Drop files here or

Max. file size: 100 MB.

Describe your products or services (check all that apply)

PARTS:

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CONSULTING OR PROFESSIONAL SERVICES:

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OUTSIDE SERVICES:

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OTHER PARTS OR SERVICES:

Describe the parts or services you provide that are not covered by the above categories.

Do you offer discounts for State or Government Contracts?*

Yes
No

Please specify*

Special licensing requirements?*

Yes
No

Please specify*

On-site work if applicable (are you able to provide) General Liability Insurance?

Yes
No

Do you have Workers Comp Insurance?*

Yes
No

Workers Comp Insurance Carrier

Contractor License # (if applicable)

Classification

Contractor License Classification (i.e., C10)

SB 854 registration number

Additional Comments

Submitted By*

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Name

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