Purchasing

Vendor Application

To be placed on the Vendor's List, please contact the Purchasing Department by calling (517)483-1785, send a written request to the following address, download the Application and mail or fill out the form below:

7130 - Purchasing Department
Lansing Community College
PO Box 40010
Lansing, MI 48901-7210

Name of Company:

Address where Bidding Forms/Purchase Orders are to be mailed:

Address Payments to be mailed Street No., City, State, Zip Code:

Phone:

Fax:

Website Address:

Email Address:

Parent Company (& Addt'l Office Locations in Michigan):

Federal ID Number:

OR

Social Security Number:

If you prefer not to submit your SS # online, please print form and fax to 517-483-5289 or call Purchasing at 517-483-1785 with your SS #. Thank You

Type of Organization:

Individual
Partnership
Corporation

Do you accept? (check all that apply)

Procurement Cards
Electronic Disk Catalog
Electronic Ordering

Dun & Bradstreet Rating (if available)

Persons to Contact and Those Authorized to Sign Bids & Contracts in Your Name (if agent, so specify)
Please list Name, Official Capacity and Telephone Number:

Do you require a hard copy of verbal orders?

Yes
No

Please List Below Classes of Equipment, Supplies, Materials and/or Services on Which You Desire to Bid

Select the category which applies to the applicant:

(A) Manufacturer or Producer
(B) Wholesaler
(C) Retailer
(D) Manufacturer's Agent
(E) Distributor
(F) Service Establishment

PLEASE COMPLETE BELOW:

Please list percentage and choose category that applies:

Minority Owned Percentage:
Minority Owned:

Women Owned Percentage:
Women Owned:

Disabled: %

Are you certified? If so, list agencies

Certificate Number:

Small Business: Yes No

Business located within Lansing Community College District: Yes
No

Please complete the following:

Standard Payment Terms:

Prompt Pay Discount:

FOB Point:

Standard Delivery Time:

Signature of Person Authorized to Sign this Application (Please Type Name)

Name and Title of Person Signing (Please Type Name and Title)

COMMODITY LIST

Please place a checkmark (√) by the appropriate code and provide a detailed description of the commodities and/or services offered. If the complete NAICS Code is known please include this number in the description area. Website URL address for NAICS is: http://www.census.gov/epcd/www/naics.html

NAICS Code

Detailed Description:

LCC Card Purchasing Program
Office Max
Preferred Online Ordering
Purchasing Links
Services & Information
Tax Exempt Form - A waiting current Tax Exempt Form - See previous form
Vendor Information

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Purchasing

Vendor Application