PROCURMENT & WAREHOUSING SERVICES DEPARTMENT VENDOR REGISTRATION FORM

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1 PROCURMENT & WAREHOUSING DEPARTMENT VENDOR REGISTRATION FORM Thank you for your interest in becoming a vendor with The School Board of Broward County, Florida (SBBC). Becoming a vendor is as simple as: 1) Complete IRS Form W-9 (Providing Tax Identification Number); 2) Complete a Vendor Registration Form; and 3) Complete the Vendor Registration: Selection List. The Internal Revenue Service requires that SBBC have on file, a completed Form W-9 for all vendors. Please complete the attached Form W-9 and submit it to SBBC with the Vendor Registration Form. Please visit the IRS website at for instructions on completing form. VENDOR REGISTRATION FORM WILL BE PROCESSED UPON RECEIPT OF ALL REQUIRED DOCUMENTATION: REQUIRED FORMS FORM W-9 LIST OF PRODUCTS/ PROVIDED PLEASE NOTE: You may , fax, or mail your Vendor Registration Form with attachments to: Purchasinghelpdesk@browardschools.com Mail: Procurement & Warehousing Services Department 7720 West Oakland Park Boulevard, Sunrise, FL Contact Person: Susan Angelson Phone: (754) Fax: (754)

2 PROCUREMENT & WAREHOUSING DEPARTMENT VENDOR REGISTRATION FORM *Required Fields. *Date: *ContactPerson: *New or update vendor: *BusinessName: *Telephone: ( ) *Facsimile(Fax): ( ) WebsiteAddress: *MailingAddress: * Address: *Federal Tax ID Number: (If None, SSN) Remit to Address: (If Different from Above) *DateBusiness Established: *Indicate which method you prefer to have purchase orders delivered: MINORITYBUSINESSSURVEY Please check the boxes below to indicate the minority status of your business. 1. Woman - Owned Business 2. African American - Owned Business 3. Hispanic -Owned Business 4. Asian - Owned Business 5. Other Fax U.S. Mail 1. Corporation 2. Individual / Sole Proprietor 3. Partnership 4. Other TYPE OF BUSINESS Please indicate on the attached what type of product/services your company provides.

3 Description 005 ABRASIVES Description MEASURING & MONITORING EQUIPMENT (PPO ONLY- 780 FOR SCALES) INSULATION & INSULATING MATERIALS 225 WATER FOUNTAINS & COOLERS 022 AGRICULTURAL EQUIPMENT & PARTS 240 CULINARY ARTS: CUTLERY, EQUIPMENT, & SUPPLIES (VOC) 025 AIR COMPRESSORS & ACCESSORIES 255 PARKING TAGS, DECALS & PASSES 031 A/C, HEAT, VENT, & FAN EQUIPMENT (EXCLUDES LIBRARY BARCODES ) 037 PROMOTIONAL & SPECIALTY ITEMS 260 DENTAL EQUIPMENT & SUPPLIES 040 ANIMALS: BIRDS & MARINE LIFE 265 CURTAINS & DRAPERIES (FOR STAGE, SEE 85522) 045 ELECTRICAL: CABLES & WIRES (EXCLUDES APPLIANCES: HOUSEHOLD & COMMERCIAL 280 ELECTRONICS) 050 ART EQUIPMENT & SUPPLIES (SEE FOR ELECTRICAL: POWERSTRIPS, LAMPS, BULBS, & 285 FURNITURE) BATTERIES, ETC. 055 AUTOMOTIVE: ACCESSORIES FOR AUTOMOBILES 287 ELECTRONICS: METROLOGY PARTS AUTOMOTIVE: SUPPLIES & EQUIPMENT 305 DRAFTING EQUIPMENT & SUPPLIES AUTOMOTIVE: TRAILER BODIES & ACCESSORIES 310 ENVELOPES VEHICLES: PURCHASE 318 LOCK & FARE BOXES 072 VEHICLES: TRUCKS (INCLUDES DIESEL, GASOLINE, & 320 FASTENERS, BOLTS, NUTS, PINS, RIVETS, ETC. ELECTRIC) 075 AUTOMOTIVE SHOP & RELATED EQUIPMENT 325 PET & VETERINARY SUPPLIES FENCE / FENCING MATERIALS (SEE FOR REPAIR/SERVICE) 080 AWARDS: TROPHIES, PLAQUES, RIBBONS, ENGRAVING, ETC BAGS, BAGGING, TIES, & EROSION SHEETING (NON- CUSTODIAL) 335 FERTILIZERS & LAWN CHEMICALS 090 BAKERY EQUIPMENT: COMMERCIAL FIRE PROTECTION DEVICES INCLUDING ALARM & SPRINKLER SYSTEMS BEARINGS - SEE CLASS 060 FOR WHEEL BEARING 345 SAFETY EQUIPMENT & SUPPLIES (NON-MEDICAL) BELTS: AUTOMOTIVE 350 FLAGS & BANNERS (SEE FOR POLES) BOATS, MOTORS, MARINE EQUIPMENT, & SUPPLIES 360 CARPET & FLOORING: MATERIALS & TOOLS (EXCL GYM) BRICKS & TILE: QUARRY, MASONRY, CLAY, & STONE 365 FLOOR MACHINES / PARTS (INSIDE BUILDING) 150 BUILDING SUPPLIES 375 FOODS: BAKERY PRODUCTS / PIZZA (FRESH) 155 BUILDINGS & STRUCTURES: PORTABLES 380 FOODS: DAIRY PRODUCTS (FRESH) 160 CAFETERIA: MEAT PROCESSING EQUIPMENT 385 FOODS: FROZEN 165 KITCHEN EQUIPMENT: SERVING LINES 390 FOODS: PERISHABLE 175 LABORATORY BALANCES & CHEMISTRY EQUIPMENT (VOCATIONAL) WATER: BOTTLED 195 TIMECLOCKS, RECORDERS, & ACCESSORIES 393 FOODS: JUICE & MILK 200 UNIFORMS: BAND, ATHLETICS, CHEERLEADER & ACCESSORIES 395 FORMS (VARIOUS PRINTING FORMS) 1 of 5

4 Description 405 FUEL 600 Description OFFICE EQUIPMENT: PURCHASE (CALCULATORS, TYPEWRITERS, ETC.) GREASE & LUBRICANTS: ALL TYPES 615 OFFICE SUPPLIES: GENERAL OIL: ALL TYPES 625 OPTICAL EQUIPMENT, ACCESSORIES, & SUPPLIES 410 FURNITURE: HEALTH CARE, (HOSPITAL) 630 PAINT, PAINT SUPPLIES, & EQUIPMENT 415 FURNITURE: LABORATORY 631 WALL COVERINGS (INTERIOR) 420 CAFETERIA: FURNITURE 640 PAPER & PLASTIC PRODUCTS: DISPOSABLE 425 FURNITURE: OTHER (SEE FOR ARTS & CRAFTS) 645 PAPER, COPY, FORMS & GENERAL OFFICE USE 435 CAFETERIA: SANITIZERS 650 EQUIPMENT, EXTERIOR: PARK, PICNIC, PLAYGRND, BENCH & BLEACHER 440 GLASS & GLAZING SUPPLIES 652 COSMETOLOGY EQUIPMENT & SUPPLIES 445 TOOLS & ACCESSORIES: NEW (HAND & POWER) 655 PHOTOGRAPHIC & I.D. EQUIPMENT & SUPPLIES 450 HARDWARE: OTHER CAFETERIA: HARDWARE CUSTODIAL: CAN LINERS (GARBAGE, TRASH, CART, ETC.) LAMINATING PRESSES, FILM, I.D. POUCHES, & SUPPLIES 460 HOSES, ACCESSORIES, & SUPPLIES: INDUSTRIAL 670 PLUMBING: SUPPLIES, EQUIPMENT, & 465 MEDICAL OCCUPATIONAL EQUIPMENT & SUPPLIES HANDICAPPED / DISABLED EQUIPMENT (INCLUDING WHEELCHAIRS) CHEMICALS, CUSTODIAL, & CAFETERIA: SUPPLIES EQUIP & PARTS CUSTODIAL: WASTE RECEPTACLES: INTERIOR & EXTERIOR PESTICIDES: (EXCLUDES FERTILZER OR LAWN CHEMICALS) 680 POLICE EQUIPMENT & SUPPLIES 700 PRINTING PLANT EQUIPMENT & SUPPLIES 710 HANDICAPPED / DISABLED: HEARING AIDS & PROSTHETIC DEVICES 490 MICROSCOPES: PURCHASE, REPAIR, & SERVICE 715 PUBLICATIONS/COPYRIGHTED MTLS (BID EX) 495 SCIENCE: LABORATORY SUPPLIES & EQUIPMENT EBOOK LIBRARY MEDIA 515 LAWN MAINTENANCE EQUIPMENT & ACCESSORIES TEXTBOOKS ONLY 525 LIBRARY EQUIPMENT & SUPPLIES TEXTBOOKS USED IN 6-12 LIT. INST. 540 LUMBER & RELATED PRODUCTS SCIENCE BOOKS 545 PRESSURE CLEANING EQUIPMENT & 720 PUMPS, PUMPING EQUIPMENT, & ACCESSORIES COMPACTORS, REFUSE (PURCHASE OF) 725 RADIO COMMUNICATIONS EQUIPMENT 550 TRAFFIC CONTROL DEVICES (EXCLUDES SIGNAGE) 726 SATELLITE RECEIVING SYSTEMS LIFTS: ALL & HYDRAULIC LIFTS, MATERIAL HANDLING EQUIPMENT STEEL / ALUMINUM / METAL: BARS & COLD / ROLLED STOCK MUSICAL INSTRUMENTS: PURCH & REPAIR (INCLUDES SHEET MUSIC) PLANTS: NEW & REPLACEMENT (SEE FOR ) 735 RAGS, SHOP TOWELS, & WIPING CLOTHS 740 ICE MACHINE, REFRIGERATION, FREEZER EQUIPMENT, & ACCESSORIES 750 ROCK, SAND, & FILL 760 ROAD & HIGHWAY EQUIPMENT: EARTH HANDLING & GRADING (NEW) 2 of 5

5 Description Description 770 ROOFING MATERIALS & SUPPLIES REFUSE (GARBAGE / TRASH) 780 SCALES & WEIGHING APPARATUS GLASS REPLACEMENT & REPAIRS (BUILDING) 785 KINDERGARTEN SUPPLIES A/C, HEATING, & VENTILATION 790 GRASS, SEED, SOD, SPRIGS, & SOIL CUSTODIAL / JANITORIAL 795 HOME ECONOMICS EQUIPMENT & SUPPLIES BUILDING MAINTENANCE, INSTALLATION, & REPAIR BOOTS & KNEE PADS FOR CUSTODIAL CLEANING PAINTING OF SCHOOLS / BUILDINGS 801 SIGNS & MARQUEES (NON-ELECTRONIC) LANGUAGE LAB SOUND SYSTEM PURCHASE & REPAIR ROOFING PEST & ANIMAL CONTROL (INCLUDING TERMITES) SIGNS, MARQUEES, & SCOREBOARDS (ELECTRONIC) SEPTIC TANK MAINTENANCE & REPAIR 810 SPRAYING EQUIPMENT (EXCLUDES HOUSEHOLD) WIRING AND OTHER ELECTRICAL MAINTENANCE 838 TELECOMMUNICATIONS EQUIPMENT, ACCESSORIES, & SUPPLIES 912 CONSTRUCTION : EXISTING FACILITIES TELEPHONE, CELL, BLACKBERRY, ETC. 913 ASPHALT & TRACK: PAVING & REPAIRS INTERCOM & PUBLIC ADDRESS SYSTEMS (PURCHASE & REPAIR) 914 CONSTRUCTION : NEW FACILITIES WIRE & CABLE: TELECOMMUNICATION ELECTRICAL: NEW CONTRUCTION 840 TELEVISION VIDEO EQUIPMENT & BLANK VIDEO TAPE 915 MAIL PRESORT / BARCODE 850 TEXTILES, FIBERS, & HOUSEHOLD LINENS ADVERTISING: NEWSPAPER, PUBLICATIONS, & RADIO 855 THEATRICAL: COSTUMES, STAGE MAKEUP, EQUIPMENT, & SUPPLIES WEB PAGE DESIGN, MANAGEMENT, & MAINTENANCE 860 TICKETS, COUPON BOOKS, & SALES BOOKS 918 CONSULTANTS / TRAINERS: EDUCATIONAL 863 TIRES: NEW (CARS, BUSES, ETC) CONSULTANTS / TRAINERS: TECHNOLOGY 870 WINDOW TREATMENTS & BLINDS (NEW) CONSULTANTS: FACILITIES & CONSTRUCTION 880 AUDIO VISUAL EQUIPMENT & SUPPLIES CONSULTANTS: ENERGY CONSERVATION 885 TANKS: CO2 FOR SWIMMING POOLS CONSULTANTS: ENVIRONMENTAL 895 WELDING EQUIPMENT, SUPPLIES, & GASES 924 EDUCATIONAL TRAINING 906 ARCHITECTURAL, PROFESSIONAL TESTING & EXAMINATION 907 ARCHITECTURAL, DRAFTING, TESTING NON- PROFESSIONAL 925 ENGINEERING, PROFESSIONAL 909 BUILDING CONSTRUCTION 926 WASTE REMOVAL 910 RUST REMOVAL ENVIRONMENTAL AND ECOLOGICAL CARPET CLEANING TANKS, CHEMICAL DILUTION, INSPECTION, & TESTING ELEVATOR MAINTENANCE & REPAIR RECYCLING REFINISH GYM FLOOR 928 VEHICLE REPAIR 3 of 5

6 Description Description GLASS REPLACEMENT & REPAIR (BUS, TRUCK, AUTO) DENTAL HEAVY EQUIPMENT & AGRICULTURAL MAINTENANCE LIFTS, HYDRAULIC PERSONNEL, INSPECTION, REPAIR, & TRAINING INDUSTRIAL HYGIENE MEDICAL : NURSING & LABORATORY GOLF CART REPAIR 952 DRUG & ALCOHOL TESTING 931 SOMAT MAINTENANCE EMPLOYEE ASSISTANCE PROGRAMS ATHLETIC SUPPLIES / EQUIP MAINT & REPAIR UNEMPLOYMENT COMPENSATION 936 EQUIPMENT MAINTENANCE / REPAIR - GENERAL 953 INSURANCE & BENEFITS - ALL ALARM EQUIPMENT MAINT / REPAIR (FIRE, ETC) 954 LAUNDRY & DRY CLEANING ELECTRICAL EQUIPMENT - EXCEPT CABLE & WIRE 956 LIBRARY (INCLUDING RESEARCH) HAND TOOL REPAIR SUBSCRIPTIONS: NEWSPAPERS & MAGAZINES SAW SHARPENING 958 RISK MANAGEMENT PRINTING EQUIPMENT REPAIR & (INCLUDING OFFSET) STAGE RIGGING, INSPECTION, REPAIR, & MAINTENANCE FUEL RELATED (FUEL TRANSPORT / CLEANUP / DISPOSAL ) OUTSOURCING FOR MANAGEMENT, OPERATIONS 938 WHEELCHAIR LIFTS & ACCESSORIES REPAIR 961 SPEECH & LANGUAGE 939 OFFICE EQUIPMENT REPAIR & CATERING AUDIO VISUAL EQUIPMENT MAINTENANCE & REPAIR COMPUTER MAINTENANCE & REPAIR INTERPRETER TEMPORARY LABOR, NON-TECHNICAL (SEE 962 FOR TECHNICAL) COPIER MAINTENANCE & REPAIR UTILITIES ENERGY MANAGEMENT CONTRACTING MICROFICHE READER / PRINTER MAINTENANCE PRINTER (MULTI-FUNCTION) MAINTENANCE & REPAIR RADIO / TELECOMMUNICTIONS / TELEPHONE EQUIP: MAINT & REPAIR 940 TELEVISION EQUIPMENT TOWER POWER GENERATION EQUIPMENT: MAINTENANCE / REPAIR / LEGAL (ATTORNEYS), COURT REPORTING LOBBYING TRAVEL AGENCY TECHNICAL / PROFESSIONAL STAFFING SVCS (96130 FOR NON-TECH) AMUSEMENT & ENTERTAINMENT 946 BANKING & FINANCIAL AUCTIONEERING RETIREMENT PLAN ADMIN & INVEST MGMT SVCS TRANSPORTATION, EXTRA CURRICULAR (SCHOOL & CHARTER) APPRAISAL : REAL ESTATE CHEMICAL TREATMENT OF BOILER & TOWER WATER AUDITING COURIER & DELIVERY 948 PHYSICAL & OCCUPATIONAL THERAPY DOCUMENT SHREDDING : CONFIDENTIAL 4 of 5

7 Description Description DOCUMENT SHREDDING : GENERAL 988 LAWN / GROUNDS MAINTENANCE MOVING PORTABLES (LEASE, PURCHASE, & RELOCATION) FENCE / FENCING : INSTALLATION, MAINTENANCE, & REPAIR LANDSCAPING & PLANT (SEE 988 FOR LAWN / GROUNDS) FIELD TRIP (GRAD NIGHT, BAND TRIPS, ETC.) TREE TRIMMING & REMOVAL STORAGE - FULL SERVICE (SEE 984 FOR COMPUTER FILES) WEED CONTROL : LAND & AQUATIC 963 REGISTRATIONS & MEMBERSHIPS 989 WATER TESTING PRINTING PREPARATION : ETCHING, PHOTOENGRAVING, ETC. PRINTING & TYPESETTING (INCLUDES DIPLOMAS) 990 POLICE & SPECIAL DETAIL (ARMED) ARMORED CAR 968 PUBLIC WORKS AND RELATED DEBRIS CLEAN UP & REMOVAL METER READING EMERGENCY MEDICAL (AMBULANCE) 971 LEASE / RENTAL FACILITIES FINGERPRINTING TOILETS: PORTABLE, RENTAL, OR LEASE SECURITY GUARD (UNARMED) 975 VEHICLE LEASING 992 CUSTODIAL: CHEMICAL TESTING CONSTRUCTION EQUIPMENT RENTAL : OTHER TESTING : NON-CHEMICAL 977 SCAFFOLDING RENTAL CALIBRATION : MISCELLANEOUS VENDING MACHINE 998 SALE OF SURPLUS & OBSOLETE ITEM BOOK AND PUBLICATION RENTAL LEASE OTHER (PLEASE SPECIFY) TENT & TARPAULIN RENTAL 983 RENTAL / LEASE : CLOTHING WORK UNIFORMS 984 STORAGE (OFF SITE) FOR COMPUTER FILES 985 MAILING / POSTAGE MACHINE RENTAL A/V EQUIP & ACCESS RENTAL / LEASE 5 of 5

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