Vendor's Application for Registration

2. City of Farmington
   Central Purchasing Division 800 Municipal Drive Farmington, New Mexico 87401 Phone: 505-599-1373

   Central Purchasing Division 800 Municipal Drive Farmington, New Mexico 87401 Phone: 505-599-1373

4. Vendor's Name:*

5. Address to which bid requests and confirming Purchase Orders are to be mailed:*

7. Vendor's Email:*

8. Address to which payments are to be mailed:*

10. Telephone Numbers:*

11. Fax Numbers:

12. Employer's Identification Number of Social Security Number: TIf you are concerned about this, please call 505-599-1373 and reference online vendor applicaiton.

14. Are you Incorporated:*
    1. Yes
    2. No

15. If Yes, what state? (abbreviate)

17. If you are certified by the State of New Mexico as a Resident Bidder reference your certification SPD#:

18. Upload a copy of your Certification

    Please upload a copy of your certificate or forward a copy and reference online submission. If you qualify as in in-state bidder but have not been Certified, please contact the State of New Mexico, Purchasing Department at 505-827-0472 for an application for resident bidder certification questionnaire. This needs to be filled out and returned to the State of New Mexico for approval.

19. Names and Titles of Officers, Members, or Owners of Concern, Partnership, etc.:

20. Upload any copies of State or GSA Contracts which you are currently participating in.

22. Official Title*

23. Date*

25. Commodity/List Book
    Click Here

26. Please list commodities not found:

28. From the Commodity List Book indicate the Commodity and Sub-Commodity for which you wish to receive Invitations to Bid:*

    Your choices should be only those products/services you can furnish. Please make your listing in numerical order following the Commodity List Book. You may use additional submissions if necessary. Please use the following format for submitting your commodity, sub-commodity listing. List the commodity separated by a hyphen, then the sub-commodity and separate each entry with a comma. Example: 255-255, 255-125, 310-410,

30. W-9 Form*

    Please upload a current, completed W-9 with your business name listed as it is with the Taxation and Revenue Department.

31. Comments:

33. Authorizing Person*

    Certification: I hereby certify that all statements made in this application are true and complete to the best of my knowledge and I understand that misrepresentation of material facts will cause forfeiture of my rights to bid with the City Central Purchasing Office.

Leave This Blank:


34. 1. Receive email copy
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field