Vendor Certification. The system hardware is listed by Underwriters Laboratories to be in compliance with UL 1741. Signed (Vendor): Date: Name (printed): Phone Number: Company:
Vendor Certification. ❑ I have read, understand and agree to comply with the 2018 CFM Vendor Manual including; Rules & Regulations and On-Site Operation Guidelines ❑ I operate my business/reside within CFM Boundaries; East of I-95 and within SC borders ❑ I understand the violations and sanctions, including suspension and disqualification ❑ I certify and understand that during harvest periods 75% of the produce I offer for sale at the CFM, as per the attached crop list, will be products grown, harvested and produced by me or an immediate family member for direct-to-consumer sales ❑ I understand that if requested by CFM Management, I must be able to provide proof of origin for any products sold at the CFM which must include; farm name, address and contact person ❑ I understand selling privileges can be revoked by the City of Charleston at any time ❑ I understand that no Farmer & Grower applicant is guaranteed acceptance and is subject to review by the City of Charleston Office of Cultural Affairs ❑ Xxxxxx & Xxxxxx applicants, who are accepted to vend in the 2018 season will be notified by the City of Charleston Office of Cultural Affairs as soon as a decision is finalized ❑ I understand that a mandatory vendor meeting will be scheduled upon acceptance Items that must be included with your Application & Participation Agreement ❑ Completed 2018 Farmer & Grower Application & Participation Agreement ❑ Full list of items the applicant intends to sell during the 2018 CFM season ❑ $20 non-refundable application fee, payable to; City of Charleston *Cash NOT accepted Items which may be submitted upon acceptance (If you have not included the following paperwork, please indicate the status of each item, whether you are awaiting acceptance or expect to have it by a certain date) ❑ 2018 City of Charleston Business License: ❑ South Carolina Retail License: ❑ SC DHEC Certificate and/or SCDA-RVC: ❑ Certificate of General Liability Insurance of no less than; $1,000,000.00: • Certificate Holder; City of Charleston – 00 Xxxxx Xxxxxx, Xxxxxxxxxx, XX 00000 The City of Charleston OCA invites eligible Farmer & Grower Vendors to participate in the 2018 season of the CFM in accordance with the guidelines and criteria outlined in this Farmer & Grower Application & Participation Agreement. While we anticipate the CFM will soon face additional space constraints arising from construction projects on sites adjacent to Xxxxxx Square and based on the park's overall capacity, we remain committed to ensuring the ...
Vendor Certification. CHECK HERE ☐ IF NON-US BUSINESS PROCEED TO ATTACHMENT B CHECK HERE ☐ IF US SMALL OR TRADITIONALLY UNDERREPRESENTED BUSINESS1- MARK BELOW ALL THAT APPLIES VENDOR NAME:
Vendor Certification. The DOE/DVR adopts the standards for vendor qualifications as those established by Florida Statutes, national certification boards and industries that are applicable. When a vendor is employed in an occupation for which national, state or industry standards have not been established, the DVR may adopt standards, as it deems appropriate, to ensure the provision of quality services to individuals with disabilities. An appeals process shall be developed to include the DVR as the final authority. (Adopted July 12, 2001.) The Contractor and any subcontractors shall comply with the DVR vendor certification standards applicable to the services for which it is contracting and shall maintain such certification throughout the term of the contract.
Vendor Certification. Vendor must remain a registered and authorized municipal advisor in accordance with the SEC’s municipal advisory rule per Sec. 975 of the Xxxx-Xxxxx Xxxx Street Reform and Consumer Protection Act.
Vendor Certification. CHECK HERE ☐ IF NON-US BUSINESS PROCEED TO ATTACHMENT B CHECK HERE ☐ IF PROCUREMENT IS ABOVE $30,000 (USG Contracts) and $25,000 (USG Cooperative Agreements and Grants) AND COMPLETE QUESTIONS 10 AND 11. The NAICS code for this procurement is 423110, and the size standard is 100 employees. For the purposes of this procurement, a small business is one that has 100 employees or less. VENDOR NAME:
Vendor Certification. CHECK HERE ☐ IF NON-US BUSINESS PROCEED TO ATTACHMENT B CHECK HERE ☐ IF US SMALL OR TRADITIONALLY UNDERREPRESENTED BUSINESS1- MARK BELOW ALL THAT APPLIES VENDOR NAME: _________________________________________________________________________ Vendor ☐is or ☐is not a U.S. based small business? (If “no” – go to question 9, and answer question 9. If “yes” – continue with question 2.) At least 51% of your company is owned by (or is more than 51% of the stock or equity owned by) one or more veterans, AND are the management and daily operations controlled by one or more veterans? ☐YES ☐NO At least 51% of your company is owned by (or is more than 51% of the stock or equity owned by) one or more service-disabled veterans, AND are the management and daily operations controlled by one or more service-disabled veterans? ☐YES ☐NO At least 51% of your company is owned by (or is more than 51% of the stock or equity owned by) one or more LGBTQ, AND are the management and daily operations controlled by one or more minority? ☐YES ☐NO At least 51% of your company is owned by (or is more than 51% of the stock or equity owned by) one or more women, AND are the management and daily operations controlled by one or more women? ☐YES ☐NO At least 51% of your company is owned by (or is more than 51% of the stock or equity owned by) one or more minority (Hispanic, Black or African American, American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander people), AND are the management and daily operations controlled by one or more minority? ☐YES ☐NO Is your company a SBA certified small, disadvantaged business? ☐YES ☐NO Is your company a SBA certified HUBZone small business concern? ☐YES ☐NO Are you, is your company, or any one of its principal officers presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal Agency? ☐YES ☐NO What is your company’s DUNS#: ___________________________? When does your XXX (System for Award Management) registration expire: __________________? ATTACHMENT B. QUOTE COVER SHEET Vendor Name: _____________________________ Physical address: ___________________________ City, State, Zip: _____________________________ Primary Contact: ____________________________ Tel: _______________________________________ Fax: _______________________________________ Email: ______________________________________ Name of Authorized Official to Sign Contract: _______________________________ Title of...
Vendor Certification. CHECK HERE ☐ IF NON-US BUSINESS- DO NO PROCEED WITH THE REST CHECK HERE ☐ IF US SMALL OR TRADITIONALLY UNDERREPRESENTED BUSINESS1- MARK BELOW ALL THAT APPLIES VENDOR NAME:
Vendor Certification. I acknowledge that electronic payments by Mecklenburg County (i.e., direct deposits) to any bank account I have designated must comply with United States Law, as well as the requirements of the U.S. Treasury Office of Foreign Assets Control (OFAC). Check only one (1) of the boxes below. ☐ I affirm that my direct deposit funds are NOT to be transferred by Mecklenburg County to a foreign bank account or to a U.S. bank for subsequent transfer to a foreign bank account. I agree to notify Mecklenburg County Accounts Payable Office immediately if I decide to change this instruction. OR ☐ I affirm that I want all of my direct deposit funds to be transferred by Mecklenburg County to a foreign bank account or to a U.S. bank for subsequent transfer toa foreign bank account. I understand that this will prevent me from participating in direct deposit and may delay my check(s). The County will also identify me as an IAT Payee. Name of Vendor Signature
Vendor Certification. I declare and certify that no member of The Board of Education of the City of Long Branch, nor any officer or employee or person whose salary is payable in whole or in part by said Board or their immediate family members are directly or indirectly interested in this Bid or in the supplies, materials, equipment, work or services to which it relates, or in any portion of profits thereof. If a situation so exists where a Board member, employee, officer of the board has an interest in the Bid, etc., then please attach a letter of explanation to this document, duly signed by the president of the firm or company.
