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2. 
4. CITY OF CRESTVIEW, FLORIDA
   VENDOR APPLICATION
6. Company Name
7. Remittance Address
   Accounts Payable
9. Contact Name
10. Address
12. Phone Number
13. City
15. Fax Number
16. State
17. Zip Code
19. Email
20. Contact Name
22. Address for Bid/Quote/RFQ request
    Please note where to send any bids/quotes/RFQ requests that your company may qualify to submit.
23. Accounts Payable Email
25. Email address
26. COMMODITY CODES
    Commodity Codes

    PLEASE LIST COMMODITY CODES YOU DESIRE TO BID OR QUOTE (Click above link for listing) or use the next section to describe types of services
28. Address
29. COMMODITY CODES
    Please list all applicable codes
31. City
32. Or list types of goods or services offered
34. State
35. Zip Code
36. Note: Purchase Order Required
    The City of Crestview requires issuance of an authorized Purchase Order to your company PRIOR to providing any services or products.
40. W9 Form
    W9

    Please use this link to open a W9 form and submit at the link to the rignt. You may use your current W9 if available.
41. W9 Form
    Please upload the completed W9 form here
43. CERTIFICATION
    I certify that the information on this application is a full, true, and complete statement of facts, and the company will provide proof of insurance – WC, GL, Auto, etc. when providing services or goods to the City of Crestview
45. E-Signature
46. Date
    Date
48. Printed name and Title
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field