SUPPLIER NAME - Marvin Group



REQUEST TO ADD/REMOVE/CHANGE SUPPLIER INFORMATION FORMCHECKBOX MEC FORMCHECKBOX MLS FORMCHECKBOX FLYER FORMCHECKBOX ALLSupplier Name: FORMTEXT ?????Vendor ID: FORMTEXT ?????Phone Number: FORMTEXT ?????Address: FORMTEXT ?????Email Address: FORMTEXT ?????(If different than remit to Address)Remit to Address: FORMTEXT ?????City: FORMTEXT ?????City: FORMTEXT ?????State: FORMTEXT ?????Zip Code: FORMTEXT ?????State: FORMTEXT ?????Zip Code: FORMTEXT ?????Contact InformationSalesFollow-upScorecard & Alert ContactName: FORMTEXT ?????Name: FORMTEXT ?????Name: FORMTEXT ?????Title: FORMTEXT ?????Title: FORMTEXT ?????Title: FORMTEXT ?????Phone: FORMTEXT ?????Phone: FORMTEXT ?????Phone: FORMTEXT ?????Email: FORMTEXT ?????Email: FORMTEXT ?????Email: FORMTEXT ?????Fax #: FORMTEXT ?????AccountingQualityList the Nature of the Supplies or Services Below: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Name: FORMTEXT ?????Name: FORMTEXT ?????Title: FORMTEXT ?????Title: FORMTEXT ?????Phone: FORMTEXT ?????Phone: FORMTEXT ?????Email: FORMTEXT ?????Email: FORMTEXT ?????Tax ID # (EIN) FORMTEXT ?????1099 filing. Yes FORMCHECKBOX or No FORMCHECKBOX (Check one)Terms: FORMTEXT ????? Account # FORMTEXT ?????Request complete W-9 or W-8?on new Suppliers.W-9?Form (Request for Taxpayer ID and Certification) is?for domestic Individual/Sole Proprietor, Corporation, and PartnershipW-8 Form (Certificate of Foreign Status) is for foreign individual/Sole Proprietor, Corporation, partnership FORMCHECKBOX W-9 FORMCHECKBOX W-8 FORMCHECKBOX Please attach any 3rd Party accreditations FORMCHECKBOX AS 9100 FORMCHECKBOX ISO 9001 FORMCHECKBOX AS 9120 FORMCHECKBOX NADCAP Attach completed MEC Form: F-043 “Supplier Export Compliance and DDTC Registration Certification”. FORMCHECKBOX FORMCHECKBOX Ensure Supplier is free of Government / Industry Data Exchange Program (GIDEP) Alerts and participates in GIDEP Alert notifications. FORMCHECKBOX System for Award Management (SAM) VerificationSurvey to be performed on Supplier? FORMCHECKBOX ON-SITE FORMCHECKBOX DESKTOP FORMCHECKBOX 3rd Party Accreditation.Business Category, check all that applyMethod of Categorization FORMCHECKBOX SB – Small Business FORMCHECKBOX Self Certification – (please fill-out attached Self-CertificationMEC Form #F-604) FORMCHECKBOX SDB – Small Disadvantaged Business FORMCHECKBOX WOSB – Women-Owned Small Business FORMCHECKBOX VOSB – Veteran-Owned Small Business FORMCHECKBOX SBA-Certification (please send copy of the Certificate) FORMCHECKBOX HUBZone – Historically Underutilized Business Zone FORMCHECKBOX SDVOSB – Service Disabled Veteran-Owned Small BusinessSupplier to submit completed forms and copies of certifications to: Export@To be filled out by MEC Purchasing Department FORMCHECKBOX add to ASL FORMCHECKBOX remove / disapprove FORMCHECKBOX CHANGE to ASL FORMCHECKBOX One time buySupplier Commodity Classification: FORMTEXT ?????Justification (required field): FORMTEXT ?????Survey Type: FORMTEXT ?????Inspection Required: FORMCHECKBOX yes FORMCHECKBOX noExpiration Date: FORMTEXT ?????Requested by: FORMTEXT ?????Date: FORMTEXT ?????Strategic Supply Chain Manager:Date: FORMTEXT ?????QA Management Approval:Date: FORMTEXT ????? ................
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