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Vendor Registration Form

  1. Registering with the city helps connect you and city staff, improving opportunities for us to do business together. Please complete and submit the form below, so that we can add you to our records.

  2. Please enter your parent company's name.

  3. If your company uses a trading-as name, please enter it here.

  4. Please enter additional information pertaining to your company's billing address (e.g. ATTN: Billing Department).

  5. Please enter additional information pertaining to your company's mailing address (e.g. ATTN: General Information).

  6. Please enter the full URL for your company's website, including the http:// prefix (e.g., http://www.mycompany.com).

  7. Product Type*

    Please select the type of product that your company sells.

  8. SWAM Code

    Please indicate if you are a small, woman-owned, or minority-owned business. A small business employs less than 50 people, realizes gross annual sales of less than $2 million, and is independently owned and operated (not a subsidiary of another firm). A Minority Business is any firm in which minority persons collectively own and share in earnings of 51% or more of the firm. Minority means Black, Hispanic, Asian, Pacific Islander, American Indian, Alaskan Native, and women, regardless of race or ethnicity.

  9. Service Disabled Veteran Business

    Veterans wishing to apply for service disabled veteran status must first seek eligibility certification from the Department of Veteran Services by calling 540-857-7101 or visiting the DVS website. Please indicate if your business is certified as a Service Disabled Veteran Business.

  10. If applicable, please enter your Virginia Department of Minority Business Enterprises certification number.

  11. If applicable, please enter the expiration date of your Virginia Department of Minority Business Enterprises certification.

  12. Purchasing Information and Order Method*

    Please select at least 1 preferred method for receiving purchasing information and purchase orders.

  13. Equipment, Supplies, or Services Provided

    Please identify equipment, supplies, materials, and/or services on which you wish to bid.

  14. Please provide your current Department of Treasury Form W-9 (Rev. December 2014). Failure to provide the current revision will delay processing of your vendor registration. All registered vendors are required to have a current W-9 on file.

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  16. This field is not part of the form submission.