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Vendor Registration Form - Please fill out the form completely and allow up to 2 week for application processing

Purchase Orders Address Remit To (if different from PO)
Name of Company Name of Company
Address Address
City City
State Zip State Zip
Contact Person Contact Person
Contact Title Contact Title
Phone Number (w/Area Code) Phone Number (w/Area Code)
Fax Number Fax Number
Email Address Email Address
TYPE OF OPERATION (CHECK ALL THAT APPLY)
Distributor Disadvantaged Business Enterprise*
Manufacturer Architectural & Engineering
Retailer Construction/Construction Management Other (Please Specify Below
Consultant Information Technology/MIS
* REQUIRED FOR DISADVANTAGED BUSINESS ENTERPRISE REGISTRATIONS
DBE CERTIFICATION AUTHORITY DBE CLASS CODES
NAICS Codes
Please select class codes from the list to the right. To select multiple codes, hold down the shift key while clicking on additional codes.
TERMS AND CONDITIONS
We have read and will adhere to the enclosed Terms and Conditions (PDF File, Acrobat Reader Required)
THE SOUTWEST OHIO REGIONAL TRANSIT AUTHORITY RESERVES THE RIGHT TO REQUEST INFORMATION CONCERNING, BUT NOT LIMITED TO, FINANCIAL STATUS OF VENDOR, BUSINESS REFERENCES, OR PROOF OF CERTIFICATION. IF YOU DO NOT RESPOND TO INQUIREIES FOR THE ABOVE REQUESTED INFORMATION YOUR NAME MAY BE REMOVED FROM SORTAS APPROVED VENDOR LIST

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