.
New Vendor Request
.
This Page may be used to request that your company be added to the University's Vendor list.

The request must be filled out in its entirety to be considered.  Separately, an IRS W-9 must be faxed to 313-577-3360.

Your application may be either printed and faxed to the University, or  submitted electronically.  Be sure to visit the section of our web site which depicts individual buyers and their responsibilities, in the categories of Research & Education, Technology, and / or  Contracts / MRO, to determine the buyer you may want to contact  to discuss the products and services your company can offer.  The links to these pages are near the bottom of our home page at http://www.purchasing.wayne.edu .
.
No purchase orders can be issued to a Vendor that is not included in the University's approved vendor list.  This form is designed to assist in the collection of data for evaluation of vendors who wish to become approved suppliers of goods and services to Wayne State University.

  Page 1  (Vendor Information)
New Vendor Application
(Request Type AddAddt'l LocationUpdate)
Type of Vendor
Regular  (Complete page one ONLY and proceed to Page 3)
Temporary Employment/Staffing Agency  (Complete page one and download the Temporary Vendor Questionnaire) Moving / Relocation Agency  (Complete page one and  download the 
Relocation Vendor Questionnaire		 Building Design or Construction (Complete Pages 1 & 2 and proceed to Page 3)
(Required fields are marked with * )
Promotional / Advertising Agency (Complete page one and download the Promotional  Vendor Questionnaire)
Date
Company Legal Name (as shown on your Federal Tax Return)*
Company Name (if different from above)
Street and No.*
City*
County*
State*    Zip Code
Telephone*
Fax No
Country United States
Other
Company 
Representative*
Representative
E-Mail  (Required to receive  an acknowledgement of acceptance)
 
   
Remit Address (If different)
Street and No.
City
State    Zip Code
Telephone 
 
 
Federal Tax ID*
F.O.B. Terms* 
Payment Terms* 
Vendor Type 
(check appropriate box)

All Vendors must download the IRS W9 (U.S.) or W-8 (International) form and fax it to the University at (313) 577-3360, attn:  Pat Wegner
** Link to the IRS Form W-9 **  (U.S.) 
** Link to the IRS Form W-8 **  (International)
 
Vendor Ownership Type   
Choose One:
(i.e. Non-Disadvantaged,
 Minority Owned, Woman
 Owned, etc)
Certifying Agency
(For all Disadvantaged Groups)
Type of  "Other" Disadvantaged 
Group
 
Conflict of Interest information:
Yes No  Are you or any Officer, Owner or Partner in this company an employee of Wayne State University?
Yes No  Are any family members employees of Wayne State University?
Commodities / Services Offered*: 
(Please see our Home Page Commodity 
Links for a Review of items we buy)

  ** Page 2  (Building Design and/or Construction Vendors Only  **

 *BONDING CAPACITY: $

Rank commodity codes Below

Vendors: Please check no more than 8 of the following commodity codes that describes your business (in ascending order ; i.e. 1,2,3…..) and 1 being the primary commodity:

    Commodity     Commodity
CZ Construction Misc/Specialty 6V Glazing
6A General Contracting 6W Curtainwall
6B Site Prep/Utilities 6X Plaster & Gypsum Board
6C Site Remediation 6Y Tile
6D Foundation 6Z Ceilings
6E Piles/Caissons 7A Flooring
6F Landscape 7B Wall Finishes
6G Paving 7C Acoustical Treatment
6H Irrigation 7D Paint & Coatings
6I Reinforced Concrete Cast-In-Place 7E Hazardous Material Remediation
6J Precast Concrete 7F Security Access & Surveillance
6K Concrete Restoration/Cleaning 7G Fire Detection & Alarm
6L Masonry 7H Fire Suppression
6M Structural Steel 7I Conveying (Elevator, Lifts, Dock Levelers, etc.)
6N Carpentry 7J Plumbing
6O Dampproofing & Waterproofing 7K HVAC
6P Roofing 7L Building Control System
6Q Sealants 7M Testing & Balancing
6R Doors & Frames 7N Electrical
6S Windows 7O Communication
6T Skylights 7P Sound & Video
6U Door Hardware 7Q Signage


  Page 3  (Submit Form - Read Instructions Below)

Stop!!  You must use the Submit Request button to send electronically - Do not use your Enter Key!!  This will not work with AOL browsers, and must be printed and faxed as indicated
If your Submission transfers successfully, you should receive a Confirmation
immediately upon completion.  You may choose to screen print the Confirmation for your records

As a reminder, all Vendors must download the IRS W9 form and fax it to the University 
at (313) 577-3360, attn:  Pat Wegner
** Link to the IRS Form W-9 **

or Mail To:
Wayne State University
attn:  Ms. Pat Wegner
Purchasing Department
Suite 4200, AAB
5700 Cass Avenue
Detroit, MI   48202
or Fax To:
(313)  577-3360
 Purchasing Home Page
Note to Vendors:
No Purchase Orders will be issued to vendors that are not on the University’s approved vendor list.  This form is designed to assist in the collection of data for evaluation of vendors who wish to become approved suppliers of goods and/or services to Wayne State University.  All areas must be completed in their entirety.  We will not accept this form if not fully completed.  The buyer assigned to this vendor evaluation must complete all remaining relevant items on this form.  The Associate Director of Purchasing will make the final determination, with the concurrence of the Director of Purchasing, if appropriate.  The performance of vendors on the approved vendor list is routinely  monitored.  If a vendor is found to be in violation of University policy in regards to its business relationship with the University, or, is unable to maintain the required level of service, the vendor will be removed from the approved list.  Reinstatement  is subject to successful application and re-evaluation.

You must provide a Social Security Number (SSN) or Federal Employer Identification Number (FEIN) in order for the University to process your payment(s).  The University is required by Federal lawwhere applicable  to report such payments along with the SSN/FEIN to Federal and State agencies where required by law.  Your failure to provide a correct name and Taxpayer Identification Number will subject your payments to a 28% federal income tax withholding. 
.
.
For technical assistance, contact webmaster