1. State of Kansas Bidders Application

Please complete this application with contact data and information for you and your company. NOTE: You only need to submit this application once, but you will need to keep the company information and email addressed current to receive bid solicitations. Please email updates to bids@da.ks.gov .

Upon completion of this application, you MUST immediately fax a copy of your current Federal W-9 Form (Request for Taxpayer Identification Number and Certification) with a signature no other than six (6) months to the Office of Procurement & Contracts at 785-296-7240. You may also email the W-9 Form to: bids@da.ks.gov . Your application will not be processed without a W-9 form with a signature no older than six (6) months. A copy of the blank W-9 form is available at the Procurement & Contracts website http://admin.ks.gov/offices/procurement-and-contracts/procurement-forms.

If you need assistance with filling out the Bidder Application Survey, please call 785-296-5419.

Questions marked with an asterisk (*) are required and must be answered to complete the application.

* 1. What is your official Company Name? (Should match the W-9 Form)

* 2. What is the URL for your Company's website?

* 3. Company Contact Person for Bidding Purposes:

* 4. Contact Person Title:

* 5. Contact Person Email (This MUST be a current email address that can receive Bidding Notices and Purchase Orders. If the email address changes you must notify the Division immediately.):

* 6. Phone Number (Please include Area Code):

* 7. Telephone Extension:

* 8. Fax Number (Please include Area Code):

* 9. What is your Company's Mailing Address?
(This must be a current address which will receive bid solicitations or correspondence. It will be your responsibility to send timely notification of any change.)

* 10. If your mailing address has additional lines, please enter them here (i.e., Suite Numbers, Postal Drops, etc.).

* 11. City:

* 12. County:

* 13. State: (2 Characters)

* 14. Postal/Zip Code (When using +4):

* 15. Please enter your 9-digit Tax Identification Number

Upon completion of this application, you MUST immediately Fax a copy of your current Federal W-9 Form (Request for Taxpayer Identification Number and Certification) to the Office of Procurement & Contracts at 785-296-7240. You may also email the W-9 Form to: bids@da.ks.gov . Your application will not be processed without the W-9 form. The W-9 must have signature no other than six (6) months.A copy of the blank W-9 form is available at the Procurment & Contracts website http://admin.ks.gov/offices/procurement-and-contracts/procurement-forms

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