Fillable Vendor Information Form (Northwestern University)

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Vendor Information Form (Northwestern University)

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The Vendor Information Form (Northwestern University) form is 1 page long and contains:

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Country of origin: US
File type: PDF

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Vendor Information Form
Company Name:
DBA (if applicable):
Contact Name:
Email Address:
Address:
STREET CITY STATE ZIP
Phone Number:
Fax Number:
Dun & Bradstreet Number:
Federal ID Number:
Company Website:
Are you currently a Northwestern University vendor?
Yes No
If yes, for which Departments/Schools?
Product or Service Offered:
Are you a diverse vendor?
Yes No
If yes, list your Certification:
Small Business (SB) Hubzone Small Business (HUBZONE)
Woman-Owned Small Business (WOSB) Small Business Program 8(a)
Veteran-Owned Business (VOB) Minority Business Enterprise (MBE)
Small Disadvantaged Business (SDB) Woman Business Enterprise (WBE)
Service-Disabled Veteran-Owned (SDVOB) Local Business Enterprise–Evanston (LBE)
Certified By:
City of Chicago CMBDC
IDOT
WBDC
Cook County Metra
CMS State of IL Other:
Small
Business
Administration
Submit this Form via Email to procurement@northwestern.edu or Fax to 847.467.5400
Submit via Email
2020 Ridge Avenue
tel: 847.491.8120
Second Floor
fax: 847.467.5400
Procurement and Payment Services
Financial Operations
Northwestern University
www.northwestern.edu/procurement
Evanston, IL 60208
procurement@northwestern.edu
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Vendor Information Form (Northwestern University)

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Completed 19 October 2020

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