VENDOR PROFILE & BID LIST APPLICATION (Please print or type) City of Grand Rapids, Grand Rapids Community College, Grand Valley State University, Interurban Transit Partnership, Kent County, Michigan Minority Business Development Council, Michigan Minority Business Enterprise Center, Procurement Technical Assistance Center (PTAC)-Muskegon First, Partners In Action Inc, Small Business Technology & Development Center, State of Michigan COMPANY NAME: Contact Name Title Address Street City/State County Zip Phone Fax Email Website REMIT PAYMENTS TO: (leave blank if same) Address Street City/State Zip Phone Fax Email Website Payment Terms Credit Card Payments Accepted: Yes No OPERATING AS: (check the one that best applies) Corporation incorporated under laws of the state of Partnership LLC PLC Sole Proprietor Non-Profit Organization Government Federal Employee Identification Number (FEIN) or Social Security # Dun & Bradstreet (Duns) # Commercial & Government Entity (CAGE) # Central Contractor Registration Completed? Yes No BUSINESS STATUS: Years In Present Business Number Of Employees Annual Sales Net Worth As Of Today Located In a Hub Zone? Yes No OWNERSHIP CLASSIFICATION: (check all that apply) African American Hispanic American Multi-Ethnic ADA Disabled Asian American Native American Woman-Owned Disadvantaged TYPE OF BUSINESS: Services Manufacturer Research & Development General Contractor Distributor Retail Subcontractor Wholesale Other Page 1 of 6
PERSON(S) AUTHORIZED TO SIGN BIDS, OFFERS AND CONTRACTS: Name Title Phone REGISTRATIONS/CERTIFICATIONS COMPLETED: (check all that apply) Central Contractor Registration Hub Zone Certified Census track or county: Michigan Department Of Transportation Michigan Minority Business Development Council Small Business Administration Small Business Administration 8(A) Small Business Administration Pro-Net Other STATUS OF ANY CURRENT/PAST CONTRACTS: Agency Type Of Contract Term Of Contract RELATIONSHIPS: Are you, member of your organization or member of your family employed by any of the Regional Alliance organizations? Yes No If yes, which Alliance organization? Organization Member Name Social Security # COMPLIANCE: All vendors shall comply and have complied with all State, Federal, and Local laws, regulations or orders applicable to the purchase, manufacture, processing and delivery of materials including but not limited to the Fair Labor Standards Act of 1938, as amended. The Equal Opportunity Clause contained in Section 202 of Executive Order 11246 and the Affirmative Action Clauses contained in 41 CFR Section 60-250.4 and 41 CFR Section 60-741.4 implementing the requirements of the Vietnam Era Veterans Readjustment Assistance Act of 1974 and the Rehabilitation Act of 1973 are hereby incorporated by reference. CERTIFICATION: The undersigned does hereby certify that the forgoing and subsequent statements are true and correct and include all information necessary to identify and explain the operations of the herein identified corporation/company as well as the ownership thereof. The undersigned agrees to provide current, complete, and accurate information on any project on which it works and any proposed changes in contractual agreement. Any misrepresentation will be grounds for terminating any contract that may be awarded in reliance heron. Signature Title Date RETURN TO: Grand Valley State University Attn: Procurement Services 201 Lake Michigan Hall Allendale, MI 49401-9403 Phone: 616-331-2280 Page 2 of 6
PLEASE PLACE A CHECK ( ) BY THE ITEMS YOU ARE INTERESTED IN SUPPLYING ANIMALS, ANIMAL CARE & CONTROL Animal Care & Control Equipment, Repair Animal Food for Zoo & Farm Animals Animal Processing Feed, Bedding, Vitamins & Supplements Rendering Services Vet Equipment/Supplies/Pharmaceuticals BUILDINGS, UTILITIES, CONSTRUCTION, MAINTENANCE & SUPPLIES Acoustic Ceilings & Walls, Cleaning, Installation & Restoration Acoustical Tile, All Types Air Conditioning, Heating and Ventilation, Equipment, Parts & Accessories Air Conditioning, Heating and Ventilation Services Asphalt Paving & Maintenance Bricks & Other Clay Products, Refractory Materials & Stone Products Building, Cleaning & Waterproofing, Exterior Builder s Supplies & Lumber Carpentry Chemicals, Industrial Concrete & Metal Culverts, Pilings, Pipe, Septic Tanks & Supplies Concrete Construction Demolition/Wrecking Services Elevators Elevator Fabricated Building Rental Fire Protection Systems & Supplies, Repair Fuel, Oil, Grease, Lubricants General Construction General Equipment HVAC Equipment Rental Heating & Air Conditioning Services Insulation & Asbestos Removal Services Leachate System Locksmith Services Millwork, Custom Overhead Doors, Installation, Repair Plumbing Plumbing Equipment, Fixtures & Supplies Portable Toilet Rental Propane & Natural Gas Refrigeration Equipment & Maintenance Roofing: Roofing Materials, Gutters & Downspouts Security Lock-Bar Installation Septic Tank Services Steam Boilers; Fittings & Accessories Storage Shelving & Lockers Steam Boiler, Heating, & Power Plant Equipment Wall Repair & Replacement (Including Drywall) Water Softening Services Water Supply & Sewage Treatment Equipment Water Treating Chemicals Page 3 of 6 Window & Door Installation, Repair Windows & Doors, Material Only CLOTHING, HEALTH, & PERSONAL USE SUPPLIES Clothing, Apparel & Accessories Laundry Cleaning Products Linens & Textiles Personal Use Supplies (Including Deodorant, Toothpaste, Etc.) Shoes & Boots Uniforms Uniform Rental DATA PROCESSING EQUIPMENT Computer Cables Computer Cable Installation Data Processing Rental/Leasing Data Processing Supplies Forms Bursters, Collators, Detachers, Feeders, Strippers & Related Laser Printers Laser Printer Supplies Mainframe Computers Mainframe Computers & Related Items Minicomputers Minicomputer Accessories & Repair Modems, Data Communications Personal Computers/Microcomputers Personal Computers, Peripherals, Accessories, Printers, Peripherals & Accessories Software Applications for Microcomputers & Personal Computers Software Applications for Minicomputers & Mainframes Software Operating System: Mainframe Software Operating System: Microcomputer ELECTRICAL EQUIPMENT & SUPPLIES Electrical Cables & Wires Electrical Equipment & Supplies Electrical Equipment Maint./Repair Services (Except for Cable & Wires, & Lighting Fixtures) Electrical Equipment Rental Electronic Components, Replacement Parts, & Accessories: Misc. Electronic Equipment Lamps: Fluorescent, Incandescent, Mercury, Vapor & Quartz Light Fixtures: Indoor/Outdoor, All Kinds Wiring, Electrical ENTERTAINMENT, EDUCATIONAL & RECREATIONAL SUPPLIES & EQUIPMENT, INCLUDING PHOTOGRAPHIC EQUIPMENT Art Objects Audio/Visual Equipment Audio/Visual Equipment Maint. & Repair Books
ENTERTAINMENT, EDUCATIONAL & RECREATIONAL SUPPLIES & EQUIPMENT, INCLUDING PHOTOGRAPHIC EQUIPMENT (Cont.) Crafts, General Films & Movies Rental Magazines Optical Equipment & Supplies Photographic Equipment Photographic Equipment Maint. & Repair Photographic Supplies (Including Film & Developing Chemicals) Film Processing Sporting & Athletic Goods Television & Video Equipment Television & Video Equipment Video Cassettes, Disks, Tapes, Etc. (For Computer & TV Prerecorded) FIRE, POLICE, RESCUE & SAFETY EQUIPMENT & SUPPLIES Ammunition Body Armor Breathing Apparatus Firearms Fire Protection Equipment & Supplies Fire Protection Equipment & Supplies First Aid & Safety Equipment & Supplies Leather: Belts, Cases, Holsters Metal Detectors Police Equipment & Supplies Police Equipment & Supplies Scuba Equipment, Targets FLOOR COVERINGS Carpet (Installed) Floor Covering, Installation, and Removal Floor Covering Material, Not Installed (Carpet and Tile) Floor Tile, All Types (Installed) FOOD, FOOD SERVICE AND KITCHENWARE AND MISCELLANEOUS APPLIANCES Appliances & Equipment, Household Type Baked Goods Coolers, Drinking Water Cutlery, Dishes, Flatware, Glassware, Trays, Utensils, and Supplies Dairy Products Dishwashing Chemicals Foods, Staple & Miscellaneous Frozen and Perishable Food Kitchen Equipment Plastic & Paper Products: Cups, Plates, Napkins Kitchen Equipment Maint. & Repair Refrigeration Equipment Refrigeration Equipment Maint. & Repair Vending Machines HARDWARE AND SHOP EQUIPMENT Air Compressors and Accessories Air Compressors Rental Barrels, Drums, Kegs, and Containers Bearings (Except Wheel Bearings & Seals) Belts: Conveyor, Elevator, V-belts Chain Saws Controlling, Indication, Measuring, Monitoring and Recording Instruments & Supplies Fasteners, Nuts, Bolts, Washer, Etc. Gases, Industrial Hardware and Related Items Hose, All Kinds Hydraulic Hose and Systems, Maint./Repair Industrial Equipment Services (Not Construction and Repair, or HVAC) Material Handling Equipment Metals: Fabricated and Structural Shapes Motor Rewinding and Repairing, Electric Polycarbonate Sheets Pumping Equipment and Accessories (Not Fire Equipment) Scales and Weighing Apparatus Tools, Hand and Stationary (Powered and Non-Powered) Welding Equipment Welding Equipment Rental JANITORIAL EQUIPMENT, SERVICES AND SUPPLIES Carpet Cleaning Floor Maintenance Machines, Parts & Accessories Germicides, Cleaners, and Related Sanitation Products Housekeeping Machines and Equipment Janitorial/Custodial Services Janitorial Supplies, General Line Mats: All Kinds Paper Towels and Toilet Tissue Window Washing Services LANDSCAPING AND GROUNDS Agricultural Equipment, Implements, & Accessories Airport Runway De-icing Material Fencing Fertilizers and Soil Conditioners Flags, Flag Poles, Banners & Accessories Landscaping Services Lawn Equipment Maintenance and Repair Lawn Equipment, Mowers, Fertilizer Spreaders Parking Lot Control Devices Parking Lot Control Devices Maint./Repair Parking Meters Plants, Flowers, Trees and Shrubs Sand and Gravel Signs, Outdoor Snow Removal Services Traffic Control Devices Page 4 of 6
MEDICAL, HOSPITAL AND LABORATORY Dental Equipment and Supplies Dental Equipment Drugs, Pharmaceuticals, Biological & Vaccine Drugs, Pharmaceuticals, and Sets (I.V.) Gases, Medical Hospital and Medical Equipment Rental Hospital and Medical Equipment & Supplies Hospital and Medical Equipment Laboratory Equipment and Supplies, Reagents and Tests Radiology Service (X-Ray) Laboratory Equipment OFFICE FURNITURE Beds and Mattresses File Cabinets, Vertical and Lateral Filing Systems: Shelf Type, Mobil & Stationary Filing Systems: Plan Files Furniture: Cafeteria, Chapel, Dormitory, Household, Lounge, School Furniture: Health Care and Hospital Facility Furniture Installation Furniture: Laboratory Furniture: Office, Conventional Furniture: Office, Modular Systems Furniture & Reupholstering Maint. & Repair Furniture Refinishing Furniture: Seating (Chairs, all types) OFFICE MACHINES, SUPPLIES AND MAINTENANCE Calculators Cash Registers Clocks, Timers, Watches Copiers Copy Machines Rental Copier Copier Supplies Dictation Equipment and Supplies Dictation Equipment Facsimile Machines Library Equipment (Laser Scanners, Optical Readers) Library Security Systems Mailing Machines and Postage Meters Master Clock Systems and Parts Microfilm Microfilm Equipment (Cameras, Readers, Reader-Printers) Microfilm/Microfiche Supplies Microfilm/Microfiche Equipment Maint./Rep. Office Machines (Not Otherwise Classified) Office Machine Rental Ribbons: Typewriter and Word Processor Ribbons: Computer and Data Processing Typewriters Typewriter OFFICE SUPPLIES Badges, Name Tags, Jewelry Engineering Equipment, Surveying Equipment Drawing Instruments and Supplies File Folders and Supplies; All Kinds Library Supplies (Not Furniture) Office Supplies, General Line Photo Identification Equipment & Supplies Signs, Indoor (Nameplates, Etc.) PAINT AND WALL COVERINGS Painting Painting Equipment and Supplies Paint, Protective Coating & Related Product Wall Coverings PAPER Computer Paper, Continuous Copy Machine Paper Facsimile Machine Paper Paper, Cut & Uncut (All Grades, Sizes, Types & Weights) PEST CONTROL SERVICES Pest Control Services PRINTING Bookbinding, Rebinding, & Repairing Election Materials Envelopes, Plain or Printed Forms, All Kinds Printing Plant Equipment Maint. & Repair Printing (Other Than Forms) Printing Equipment & Supplies Typesetting PROFESSIONAL SERVICES Advertising Advertising, Public Relations Aerial Photography & Mapping Services Ambulance Service Appraisal Services (Other than Real Estate) Appraisal/Valuation Services, Real Estate Auctioneer Services Auditing Services Banking Services Building Design Services Cadaver Removal Services Cafeteria Services Cash/Securities & Bonding Services Catalog Services Catering Services Collection Services Computer Programming Personnel Consulting, Computer Consulting (Not Otherwise Classified) Courier/Delivery Services Data Processing & Software Services Dental Services Dry Cleaning Educational Services Electrostatic Painting Engineering Services Page 5 of 6
PROFESSIONAL SERVICES (Cont.) Entertainment, Speaker Extradition Services Film Production Financial Advisor, Bond Counsel Graphic Design Hazardous Materials Clean-Up & Removal Hospital Food Service Management Human Services Installation Services (Not Otherwise Classified) Insurance & Risk Management Interior Design/Decorator Services Laboratory Services Laundry Services Legal Services Leasing & Finance Services Licenses & Memberships Mailing Services Microfiche/Microfilming Services Medical & Hospital Services Moving & Hauling Services Newspaper & Magazine Subscriptions Office Space Rental/Leasing Personnel, Temporary Pharmaceutical Services Professional Journal Subscriptions Physicians Services Photography (Other Than Aerial) Radio Commercial Production Remonumentation & Maintenance Reproduction & Graphic Services (Including Blueprints) Research Services Room Rental for Conference, Seminar, Etc. Security Guards Surveying Telecommunications Consulting Television Commercial Production Towing Services Translation Services Transportation Services Travel Agency Services Veterinary Services Video Production & Recording Video Scanning Sewers, Water Wells, Etc. VEHICLES & TRANSPORTATION Agricultural Equipment Parts & Accessories Automobiles, Vans Automotive & Truck Accessories Automotive & Truck Body Repair Automotive Bodies, Accessories, & Parts Automotive Bodies & Accessories Automotive Engine Oil Automotive Glass Replacement Automotive Automotive Maintenance Items & Repair/Replacement Parts Automotive Shop Equipment Automotive Shop Equipment Maint./Repair Page 6 of 6 Boats, Boat Trailers, Outboard Motors Boats, Motors, & Other Marine Equipment Earth Handling, Grading, Moving, & Packing Equipment Fire Apparatus Fire Protection, Pumpers, Crash & Rescue Trucks Gasoline Machinery & Earth Handling Equipment Rental Road & Highway Equipment Rental Shuttle Buses Tires & Tubes Trailers (Other Than Boats) Trucks, 1 Ton & Less Trucks, Over 1 Ton Trucks, Over 1 Ton VOICE & DATA COMMUNICATIONS EQUIPMENT Cellular Phones Communications Systems: TV, Microwave, Telephone, Fiber Optics Communications Systems: Radio Microwave, Intercom Systems Radio Communications, Equipment, Accessories, & Supplies Telephone Systems, Cellular Phones, Pagers Rental Security Systems: Intruder & Smoke Detection Sound Systems, Components, & Accessories, (Including Intercom Systems) Telephone & Telecommunications Equipment Telephone & Telecommunications Equipment, Accessories & Supplies Towers Towers, Radio & Radar Etc., Maintenance & Repair (Including Tower Painting) WASTE HAULING Recycling Services Waste Hauling Services WINDOW COVERINGS Awnings & Shades Blinds and Draperies Cleaning & Repair Draperies & Cubicle Curtains Drapery Installation & Repair Vertical & Horizontal Blinds 09.09