BUSINESS NAME/DBA NAME/TA NAME FEDERAL TAXPAYER NUMBER (If different than the Full Name) (If different than ID# above) BILLING NAME FEDERAL TAXPAYER NUMBER (Company name as it appears on your invoice) (If different than ID# above) PURCHASE ORDER ADDRESS PAYMENT ADDRESS CONTACT NAME/TITLE (PRINT) SIGNATURE (IN INK) DATE E-MAIL ADDRESS TELEPHONE NUMBER TOLL FREE TELEPHONE FAX NUMBER NUMBER *BUSINESS LARGE SMALL WOMEN-OWNED CLASSIFICATION *Business Classification definitions can be viewed at *Is your Classification certified by the Virginia Department of Small If yes, provide Certification Number: Business and Supplier Diversity (SBSD)? Yes No *For assistance with certification questions, please visit: I acknowledge that I have received the following addendums posted for this solicitation. 1 _____ 2 _____ 3 _____ 4 _____ 5_____ 6_____ (Please check all that apply) Is any member of the firm an employee of the Commonwealth of Virginia who has a personal interest in this contract pursuant to the Code of Virginia? YES____________ NO_____________ SIGNATURE _____________________________________ Date: _______________________ THIS IS NOT AN ORDER Revised 01/01/2018 I. PURPOSE: The intent and purpose of this Invitation for Sealed Bid is to purchase Tektronix Equipment for Virginia Polytechnic Institute and State University (Virginia Tech), an agency of the Commonwealth of Virginia. II. SMALL, WOMAN-OWNED AND MINORITY (SWAM) BUSINESS PARTICIPATION: The mission of the Virginia Tech supplier opportunity program is to foster inclusion in the university supply chain and accelerate economic growth in our local communities through the engagement and empowerment of high quality and cost competitive small, minority-owned, women-owned, and local suppliers. Virginia Tech encourages prime suppliers, contractors, and service providers to facilitate the participation of small businesses, and businesses owned by
BUSINESS NAME/DBA NAME/TA NAME (If different than the Full Name) FEDERAL TAXPAYER NUMBER (If different than ID# above) BILLING NAME (Company name as it appears on your invoice) FEDERAL TAXPAYER NUMBER (If different than ID# above) PURCHASE ORDER ADDRESS PAYMENT ADDRESS CONTACT NAME/TITLE (PRINT) SIGNATURE (IN INK) DATE E-MAIL ADDRESS TELEPHONE NUMBER TOLL FREE TELEPHONE NUMBER FAX NUMBER *BUSINESS CLASSIFICATION LARGE SMALL WOMEN-OWNED *Business Classification definitions can be viewed at *Is your Classification certified by the Virginia Department of Small Business and Supplier Diversity (SBSD)? Yes No If yes, provide Certification Number: *For assistance with certification questions, please visit: I acknowledge that I have received the following addendums posted for this solicitation. 1 _____ 2 _____ 3 _____ 4 _____ 5_____ 6_____ (Please check all that apply) Is any member of the firm an employee of the Commonwealth of Virginia who has a personal interest in this contract pursuant to the Code of Virginia? YES____________ NO_____________ SIGNATURE _____________________________________ Date: _______________________ THIS IS NOT AN ORDER Revised 01/01/2018 I. PURPOSE: The intent and purpose of this Invitation for Sealed Bid is to purchase Tektronix Equipment for Virginia Polytechnic Institute and State University (Virginia Tech), an agency of the Commonwealth of Virginia. II. SMALL, WOMAN-OWNED AND MINORITY (SWAM) BUSINESS PARTICIPATION: The mission of the Virginia Tech supplier opportunity program is to foster inclusion in the university supply chain and accelerate economic growth in our local communities through the engagement and empowerment of high quality and cost competitive small, minority-owned, women-owned, and local suppliers. Virginia Tech encourages prime suppliers, contractors, and service providers to facilitate the participation of small businesses, and businesses owned by