AUTHORIZED SERVICING DEALER & MAUNFACTURER
Authorized Dealer Form
AUTHORIZED DEALERS
Per Section 3.1 of the ITN, “Authorized Dealer” means an agent/reseller/dealer/subcontractor authorized by the Manufacturer, in writing, to provide products and/or services under the DIRECT SUPERVISION of the Manufacturer.
Please list below all authorized dealers that will be providing product or service by participating on your State Contract.* Please note that any dealer receiving orders on this contract must be registered in MyFloridaMarketPlace and with the Division of Corporations.
The following information must be completed in its entirety for each dealer:
Dealer Name: Integral Consulting Services, Inc. (Small Business – 8(a), WO)
Dealer Address:704 Quince Orchard Road, Suite 290
City, State, Zip Code: Gaithersburg, MD, 20878
Office Phone/Fax: 301-990-0880 / 301-294-4673
Email Address: ajohri@
Contact Person: Abhai John
Vendor Tax ID Number: 52-2081090
*Please identify any CMBE (Certified Minority Business Enterprise) dealers participating in this contract.
Certified 8(a),woman-owned SDB
CMMI Level 2 Certified
(This form may be duplicated as necessary.)
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