CAFI SUPPLIER INFORMATION FORM

Vendor Information Form
DATE*

MonthDayYear
Date
LEGAL NAME*
DBA
FIN OR SSN*
PHYSICAL ADDRESS
Address

STREET ADDRESS

Street Address Line 2

CITYSTATE

ZIP CODE
WEB SITE
PHONE
MAILING ADDRESS
SAME AS ABOVE?

Yes
STREET ADDRESS or PO
CITY
STATE
ZIP CODE
SALES CONTACT INFORMATION
NAME
EMAIL
example@example.com
TITLE
PHONE
FINANCE CONTACT INFORMATION
NAME
EMAIL
example@example.com
TITLE
PHONE
TYPE OF SUPPLIER
TYPE OF SUPPLIER

INDEPENDENT CONTRACTORSERVICE PROVIDERUTILITYREPAIRINSTRUCTOROther
PROGRAM INTENDED

HEAD STARTWEATHERIZATIONSERVICE CENTERCAFI
FORM SUBMITTED ON

MonthDayYear
Date
W9 Upload

Cancelof
CAFI FISCAL DEPT ONLY
SUPPLIER PACKET VERIFIED BY
SUPPLIER APPROVED CREDIT LINE OF
CREDIT APPLICATION ATTACHED
ACCOUNT
CAFI APPROVAL
LOGIN OR USER ID
PASSWORD
Should be Empty:

Vendor Information Form