Vendor Application

Application

Vendor Application

All vendor information must be complete for your company to be an approved vendor to the City of Nixa. A completed and signed W-9 form must accompany the application.
Physical Address
Billing Address (if different)
Billing Contact
Purchasing Contact
Incorporated?
What category of services or products does this business provide? i.e. construction, food service, IT services, etc.
Will you accept purchase orders?
Are you or a family member employed by the City of Nixa?
If yes, provide name of employee and your relationship to them. 

Additional Information

Name of city contact you have been working with(Required)
Payment Terms

How is your business organized?

Name or Names of Principal Owner(s)
Name (if applicable)
Name (if applicable)

Please Provide 2 Current Client References Relevant to the Products or Services You Plan to Sell to the City of Nixa

Contact Name
Address
Contact Name
Address
Max. file size: 100 MB.
This form requires a pdf attachment of your current W-9 prior to submission.
This field is for validation purposes and should be left unchanged.