BID LIST INFORMATION SHEET

                                                                                                            Date:_________________

Vendor Information:

                                                                                                Place Orders & Send Bids:                   Remit to:

Name:__________________________________      _____________________________________

Street:___________________________________                _____________________________________

City:____________________________________     _____________________________________

State & Zip:______________________________     _____________________________________

Sales Representative:__________________________________________________________________

E-mail address:_______________________________________________________________________

State of Utah Sales Tax License Number:_________________ Telephone#:______________________

Federal Tax I.D. Number:_____________________________   Fax Number:_____________________

Local City or County Business License Number:____________________________________________

Address of Available Inventories:________________________________________________________

Enclosed is a check or money order payable to Weber County for the annual vendor’s fee in the amount of: (please check one)
                                ____ $25.00 (In-State) ____ $55.00 (Out-of-State)    **Total Enclosed $_______

** Note: The above fee entitles the vendor to receive bids on a maximum of up to 5 different commodity codes.  Vendors wanting to be included on 6-10 would double the vendor fee; 11-15 would triple the vendor fee, etc.

____ No payment enclosed.  My company does not want to be included on the County purchasing commodity list at this time.  We would like to continue to do business with the County through notifications in legal ads.  We understand that it is our responsibility to contact the Purchasing Department periodically and pick up any RFP’s or bids  which are of interest to us.

I have paid the required fee, please include my company on the following commodity bid and proposal lists.
1.____________________________________ 6.__________________________________________
2.____________________________________ 7.__________________________________________
3.____________________________________ 8.__________________________________________
4.____________________________________ 9.__________________________________________
5.____________________________________ 10._________________________________________
__________________________________________________________________________________

While Weber County can’t offer preferential treatment, it is the policy of this division to encourage Minority Business Enterprises (MBE) & Women Owned Business Enterprises (WOE) in all of its procurement practices and to provide equal opportunities to compete for contracts for construction, professional services, and purchase of equipment and supplies.

Business Certification:

____ WOE ____Black ____ Native American ____ Asian-Pacific ____ Hispanic

Weber County attempts to solicit competitive prices for all major purchases.  The above information is used to give vendors an equal opportunity to participate in the County’s business.  Because there are often many vendors supplying the same or similar items, it is necessary at times to send Requests for Bid to a limited number of vendors.  However, unsolicited bids are always welcomed by Weber County.

I understand that the County is not liable for requests/solicitation for bids which are not received due to commodity code error, change of address, untimely delivery of the postal service or requisition clerk/buyer error.  Such errors do not invalidate any other bids received in a timely manner.

I understand that my company may be removed from the bidder’s list for failure to pay the annual bid fee, unethical practices, misrepresentation of merchandise, and/or failure to respond on three consecutive bids.

I certify that I am an authorized agent for my company.

_______________________________________________________                 ____________________
Signature of Authorized Company Representative & Title                                   Date