DISTRICT SCHOOL BOARD OF PUTNAM COUNTY BIDDERS MAILING LIST APPLICATION Mail To: Telephone Number Purchasing Department 386-329-0517 1001 Husson Ave. Fax Number Palatka, Florida 32177 386-329-0521 Vendor No Assigned: For Procurement Use Only Date Assigned: Name of Business: This name will be used on purchase orders and checks issued to your company. Telephone Number Registered Organization Type: Sole Proprietorship/Individual Fictitious Name Out of State Corporation In-State Corporation Non-Profit Organization Partnership Exempt from Registration Website Address Bondable yes no Federal Employer Identification Number - _ If None _ - _ - Signature Contact Number: Telephone Number/Toll Free Number Fax Number (Order Department) Contact Person: Name Email Address Owner/Gender Classification: African American Hispanic Asian American American Indian/Alaskan Native Female Other Type of Business: Manufacturer/Producer Wholesaler Retailer Manufacturer s Agent Service Establishment Jobber Distributor Agent, Representative or Employee Authorized to transact business on behalf of entity/firm: Name and Title Name and Title Revised: 09/25/09 1
Are any Officers, Owners or Partners employees of the District School Board of Putnam County? Yes No References Customers: Financial References: Certification: I certify the information supplied herein, including all pages attached, is correct and that neither the applicant nor any person (or concern) in any connection with the applicant as a principal officer so far as is known, is now debarred or otherwise declared ineligible by the State of Florida or the District School Board of Putnam County to bid on furnished materials, supplies, or services for the School Board or any agency thereof. Note: Failure to respond to three consecutive bid requests may be cause for suspension from bidder s mailing lists. All applications are subject to review and investigation prior to validation for placement on approved bidder s mailing lists. Signature Title Date Revised: 09/25/09 2
COMMODITIES: Please mark only those categories for goods and services which are the firm s normal business activities and which you wish to receive bid requests. Check the box(s) closest to the commodity that you offer. DO NOT write in your own commodity. A C 005 010 012 020 025 030 035 037 040 045 050 055 060 065 070 075 077 080 085 090 095 100 103 110 115 120 125 130 133 Accounting/Auditing Services Acoustical Tiles Acrylic Coating for Outdoor Sports Agricultural Equipment and Supplies Air Conditioning Equipment and Supplies Air Conditioning Ventilation, Ducting Equipment and Supplies Appliances, Household Aquatic Control Services Architectural Services Armored Car Services Art Equipment and Furniture Art Paper Products Arts and Crafts Supplies Asbestos Abatement Consulting Services Asbestos Abatement Contractor Services Asphalt Maintenance and Repair Athletic Grounds Maintenance Athletic/Physical Education Equipment and Supplies Athletic/Physical Education Equipment Inspections and Repair\ Athletic Training Equipment Auctioneering Services Audio Visual/Video Equipment and Supplies Audio Visual/Video Equipment Repair Services Auditory Training Equipment Automotive Batteries Automotive Equipment and Supplies Automotive Parts and Accessories Automotive Repair Service Awards and Incentives 187 188 190 195 198 205 210 215 220 225 230 235 240 245 250 255 260 265 270 273 275 280 285 290 295 300 305 310 315 Cafeteria Hood Ventilation Inspections and Cleaning Carpentry Services Carpentry Supplies Carpet Carpet Cleaning Services Chalkboards, Tackboards and Markerboard Charter Bus Service Chillers and Cooling Towers Classrooms and Office Equipment Classroom and Office Equipment Repair Services Classrooms and Office Furniture Classroom and Office Paper Products Classroom and Office Supplies Closed Circuit Television Parts, Accessories and Services Coffee Service Communications Equipment Compactor, Trash Computer Hardware, Peripherals, Software and Supplies Computer Networking Services Computer Repair Parts Computer Repair Services Computer Training Services Construction Paper Copier Rentals Cosmetology Equipment and Supplies Custodial Cleaning Services Custodial Equipment Custodial Paper Products Custodial Supplies B D 135 140 145 150 152 155 160 162 165 170 175 180 Backflow Prevention Inspections and Repair Bakery Products Band Uniforms Banking Services Batteries, Dry Cell Beverage Services Bleacher Repair Blueprint Printing Services Boilers, Gas and Water Bond Paper Building Contractors Building Materials 320 322 325 330 335 340 345 350 Data/Communication Wiring (Retrofit) Day Care/Pre-School Services Demolition Services Dental Equipment and Supplies Detergents, Food Service Diplomas Drafting/Industrial Arts Furniture Drapes and Stage Curtains Revised: 09/25/09 3
E I 360 365 370 375 380 382 385 390 392 395 400 405 406 410 415 420 425 417 430 435 440 445 450 455 460 465 470 475 480 485 487 490 495 505 510 512 515 517 Electrical Contractor Electrical/Electronic Equipment Electrical/Electronic Supplies Elevator/Wheelchair Lift Services, Repair, Inspection and Recertification Emergency Medical Equipment and Supplies Employee Benefits Consulting Services Energy Management Services Engineering Services Environmental Remediation Services Environmental Services Equipment Rentals, Industrial F Fencing Fertilizer Fire Alarm Equipment and Supplies Fire Alarm/Security Monitoring Services Fire Protection Equipment and Supplies Fire Sprinkler/Pump Inspections and Repair Fire Suppression System Inspections and Maintenance First Aid/Clinic Equipment and Supplies Flags, Flagpoles and Accessories Food Service Equipment Large Food Service Equipment Small Food Service Paper Products Foods, Direct Delivered Freon, Refrigeration Frozen Desserts Fuels, Gasoline and Diesel Fuel G Glazier Materials and Services Grease Trap Cleaning Grounds Keeping Equipment and Supplies Gymnasium Floor Refinishing H Hand Tools Hazardous Materials Disposal Heating Equipment and Supplies Home Economics Equipment and Supplies Hurricane Shutters HVAC Repair Services HVAC Test and Balance Services 520 525 528 530 532 535 002 163 540 402 403 404 462 500 543 583 673 800 851 869 907 920 995 545 548 550 555 560 565 570 575 572 580 582 585 590 595 605 610 615 625 631 632 635 640 645 Ice Machines Identification Systems Industrial Heavy Equipment Industrial Arts Equipment Supplies Instructional Aids Instructional Materials Insurance Accident Insurance Boiler and Machinery Insurance Consulting Services Insurance Errors and Omissions Insurance Excess Property Insurance Excess Workers Compensation Insurance Fringe Benefits Insurance Health Insurance Intern Accident Insurance Liability and Corrective Action Insurance Miscellaneous Commercial Insurance Property Liability Insurance School Board Liability Insurance Sexual Misconduct Liability Insurance Storage Tank Insurance Student Insurance Workers Compensation Irrigation Equipment and Supplies Irrigation Services ITFS Equipment and Supplies ITSF System Repair Services L Landscape Design Services Landscaping Services and Supplies Laundry Equipment and Supplies Law Enforcement Equipment and Supplies Lawn Maintenance Services Leak Detection Services, Domestic Water Legal Services Library Books Library Materials Lift Station Inspections and Repair Locksmith Parts, Accessories and Services Lockers and Parts Lubricants, Motor Oil and Automatic Transmission Fluids M Maps, Globes and Charts Marketing Services Marine Mechanics Equipment and Supplies Material Handling Equipment and Supplies Medical Equipment and Supplies Medical/Nursing Services Revised: 09/25/09 4
M S 650 652 655 660 665 670 675 680 685 690 700 705 710 715 720 723 725 730 732 735 737 745 750 755 760 765 770 775 785 787 790 793 795 798 805 Metal Fabrication Services Microbial Remediation Microfiche/Microfilm Equipment and Supplies Microfiche/Microfilming Services Milk, Dairy Products, Milk Shake Mix and Juice Mini-Blinds and Verticals Moving Relocatable Buildings and Trailers Moving Services Musical Instruments and Accessories Musical Instrument Repair O OT/PT Services Overhead Door Repairs P Pager Rentals Pagers/Cellular Telephones Paint and Paint Supplies, Industrial Painting Contractors Painting Equipment and Accessories, Industrial Pest Control Chemicals Pest Control Equipment and Supplies Pest Control Services Pesticides Grounds Maintenance Physical Therapy Equipment and Supplies Pigeon Control Services Playground and Park Products Playground Equipment Inspections and Repair Plumbing Contractors Plumbing Equipment and Supplies Portable Classroom Rentals Power Tools Pressure Washing Services Printing Equipment and Supplies Printing Services Professional Books Professional Materials Public Address Equipment and Supplies 845 850 853 857 855 860 865 868 870 875 880 885 895 900 903 905 906 910 915 925 930 935 940 945 947 955 960 963 965 967 970 973 974 Safety Equipment and Supplies Sand, Golf Course School Bus Batteries School Bus Printing Services School Bus Parts and Accessories Science Equipment and Supplies Security Contracts Security Equipment and Supplies Sheet Music Shelving Sign Equipment and Supplies Sign Language Services Soils and Materials Testing Services Solar Film Speech Therapy Services Special Student Transportation Stage Equipment Storage Trailer Rentals Structural Engineering Services T Teaching Aids Telecommunications Equipment and Peripherals Temporary Employment Services Tennis Court Resurfacing Testing Materials Testing services Evaluator Tires and Service Towers, Broadcasting and Microwave Training Materials Transmissions Tree Trimming and Removal Services Turf Maintenance Materials Tutoring Services U Uniforms V R 975 Vehicles 810 815 820 825 830 835 838 840 843 Radios, Two Way Refrigeration Equipment and Supplies Resilient Floor Tile and Linoleum Resuscitation Training Aids Road Building Materials Roof Cleaning Services Roofing Consulting Services Roofing Contractor Roofing Materials 980 985 990 W Water Treatment Services, Chillers/Boilers Welding Equipment and Supplies Well Drilling/Capping Services Revised: 09/25/09 5