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Application - City of La Vergne Vendor's ListCITY OF LA VERGNE VENDOR’S LIST APPLICATION 5093 MURFREESBORO ROAD TELEPHONE # (615) 793-6295 LA VERGNE, TN 37086 FAX # (615) 793-6025 http://www.lavergne.org Please complete all information requested on this form and return it to the address noted above. Submission of this form will provide the City of La Vergne with a database of vendors that can meet departmental needs for commodities and services. A bid notification will be faxed to all vendors who can provide the commodities or services. If you do not have a fax machine, you will not be notified, however, all bids are advertised in the Daily News Journal and on the City of La Vergne website. All bids are available for review in the Purchasing Office located at the City Hall building. Please notify the Purchasing Department immediately of any and all changes to the information on this application. 1. FEDERAL TAX ID# OR SOCIAL SECURITY #: 2. CITY OF LA VERGNE BUSINESS TAX#: 3. RUTHERFORD COUNTY BUSINESS TAX#: 4. TENNESSEE SALES TAX #: 5. APPLICANT’S NAME & MAILING ADDRESS FOR BID FORMS AND PURCHASE ORDERS: 6. MAILING ADDRESS FOR PAYMENTS (IF DIFFERENT): 7. PERSON(S) TO CONTACT CONCERNING BIDS OR QUOTES: NAME OFFICIAL CAPACITY TELEPHONE # FAX # 8. IS YOUR COMPANY A SMALL BUSINESS AS DEFINED BY THE U.S. SMALL BUSINESS ADMINISTRATION? YES NO 9. ARE YOU A GOVERNMENT AGENCY OR A NON-PROFIT ORGANIZATION? GOVERNMENT AGENCY: YES NO NON-PROFIT: YES NO 10. ARE YOU INCORPORATED? YES NO 11. IF YES, ARE YOU PUBLICLY TRADED? YES NO 12. WHAT IS THE GENDER OF THE OWNER? FEMALE MALE 13. IDENTIFY COMPANY OWNER CLASSIFICATION: HISPANIC OR LATINO AMERICAN INDIAN OR ALASKA NATIVE ASIAN NATIVE HAWAIIAN BLACK OR AFRICAN AMERICAN CAUCASIAN OTHER 14. IS YOUR BUSINESS CLASSIFIED AS A DISADVANTAGED BUSINESS? YES NO OTHER ________________ 15. ARE YOU AWARE OF ANY FAMILIAL RELATIONSHIPS OR BUSINESS RELATIONSHIPS BETWEEN ANY MEMBER OF YOUR FIRM AND ANY EMPLOYEE OR OFFICIAL OF THE CITY OF LA VERGNE? YES NO - IF YES, PLEASE EXPLAIN THE NATURE OF THE RELATIONSHIP: 16. I HEREBY CERTIFY THAT THE INFORMATION SUPPLIED HEREIN IS CORRECT. _________________________________________ ____________________________________ TYPE OR PRINT NAME AND TITLE SIGNATURE OF PERSON SIGNING APPLICATION CLASS LIST Please place a checkmark(9999) by items you are interested in supplying. ___ 005 Abrasives ___ 010 Acoustical Tile, Insulating Materials, and Supplies ___ 015 Addressing, Copying, Mimeograph, and Spirit Duplicating Machine Supplies, Chemicals. Inks, Paper, Etc. ___ 019 Agricultural Crops and Grain including Fruits, Melons, Nuts, and Vegetables ___ 020 Agricultural Equipment, Implements, and Accessories ___ 022 Agricultural Implement and Accessory Parts ___ 025 Air Compressors and Accessories ___ 031 Air Conditioning, Heating, and Ventilating: Equipment, Parts and Accessories (See Related Items In Class 740) ___ 035 Aircraft and Airport, Equipment, Parts, and Supplies ___ 037 Amusement, Decorations, Entertainment, Toys, Etc. ___ 040 Animals, Birds and Marine Life Including Accessory Items (Live) ___ 045 Appliances and Equipment, Household Type ___ 050 Art Equipment and Supplies ___ 052 Art Objects ___ 055 Automotive Accessories for Automobiles, Buses, Trucks, Etc. ___ 060 Automotive Maintenance Items and Repair [Replacement Parts) ___ 065 Automotive Bodies, Accessories, and Parts ___ 070 Automotive Vehicles and Related Transportation Equipment ___ 075 Automotive Shop Equipment and Supplies ___ 080 Badges, Emblems, Name Tags and Plates, Jewelry, Etc. ___ 085 Bags, Bagging. Ties, and Erosion Control Equipment ___ 090 Bakery Equipment, Commercial ___ 095 Barber and Beauty Shop Equipment and Supplies ___ 100 Barrels, Drums, Kegs, and Containers ___ 105 Bearings (Except Wheal Bearings and Seals - See Class 060) ___ 110 Belts and Belting: Conveyor, Elevator. Power Transmission, and V-Belts ___ 115 Biochemical, Research ___ 120 Boats, Motors, and Marine and Wildlife Supplies ___ 125 Bookbinding Supplies ___ 135 Bricks and Other Clay Products, Refractory Materials, and Stone Products ___ 140 Broom, Brush, and Map Manufacturing Machinery and Supplies ___ 145 Brushes (Not Otherwise Classified) ___ 150 Builder's Supplies ___ 155 Buildings and Structures: Fabricated and Prefabricated ___ 160 Butcher Shop and Meat Processing Equipment ___ 165 Cafeteria and Kitchen Equipment, Commercial ___ 175 Chemical Laboratory Equipment and Supplies ___ 180 Chemical Raw Materials (in Large Quantities Primarily for Manufacturing Janitorial and Laundry Products) ___ 190 Chemicals and Solvents, Commercial (in Bulk) ___ 192 Cleaning Compositions, Detergents, Solvents, and Strippers - Prepackaged ___ 193 Clinical Laboratory Reagents and Tests (Blood Grouping, Diagnostic. Drug Monitoring, Etc.) ___ 195 Clocks, Timers, Watches, and Jewelers' and Watchmakers' Tools and Equipment ___ 200 Clothing, Apparel, Uniforms, and Accessories ___ 201 Clothing Accessories (See Class 800 for shoes and boots) ___ 204 Computer Hardware and Peripherals for Microcomputers ___ 206 Computer Hardware and Peripherals for Mini and Main Frame Computers ___ 207 Computer Accessories and Supplies ___ 208 Computer Software for Microcomputers (Preprogrammed) ___ 209 Computer Software for Mini and Main Frame Computers (Preprogrammed) ___ 210 Concrete and Metal Culverts, Pilings, Septic Tanks. Accessories and Supplies ___ 220 Controlling, Indicating, Measuring, Monitoring. and Recording Instruments and Supplies ___ 225 Coolers, Drinking Water (Water Fountains) ___ 232 Crafts, General ___ 233 Crafts, Specialized ___ 240 Cutlery, Dishes, Flatware, Glassware, Trays, Utensils, and Supplies ___ 245 Dairy Equipment and Supplies ___ 250 Data Processing Cards and Paper ___ 255 Decals and Stamps ___ 260 Dental Equipment and Supplies ___ 265 Draperies, Curtains, and Upholstery Material (including Automobile) ___ 269 Drugs and Pharmaceuticals ___ 271 Drugs, Pharmaceuticals, and Sets (For Large-Volume Parenteral Administration, Infusion, Irrigation, and Tube Feeding) ___ 280 Electrical Cables and Wires (Not Electronic) ___ 285 Electrical Equipment and Supplies (Except Cable and Wire) ___ 287 Electrical Components, Replacement Parts, and Accessories: And Miscellaneous Electronic Equipment ___ 290 Energy Collecting Equipment and Accessories: Solar and Wind ___ 295 Elevators and Escalators, Building Type ___ 305 Engineering Equipment, Surveying Equipment, Drawing Instruments, and Supplies ___ 310 Envelopes, Plain or Printed ___ 315 Epoxy Based Formulations for Adhesives, Coatings, and Agents ___ 318 Fare Collection Equipment and Supplies ___ 320 Fastening, Packaging, Strapping, Tying Equipment and Supplies ___ 325 Feed, Bedding, Vitamins and Supplements for Animals ___ 330 Fencing ___ 335 Fertilizers and Soil Conditioners ___ 340 Fire Protection Equipment and Supplies ___ 345 First Aid and Safety Equipment and Supplies (Except Nuclear and Welding) ___ 350 Flags. Flag Poles, Banners, and Accessories ___ 360 Floor Covering, Floor Covering Installation and Removal Equipment, and Supplies ___ 365 Floor Maintenance Machines, Parts, and Accessories ___ 370 Food Processing and Canning Equipment and Supplies ___ 375 Foods: Bakery Products (Fresh) ___ 380 Foods: Dairy Products (Fresh) ___ 385 Foods, Frozen ___ 390 Foods: Perishable ___ 393 Foods: Staple Grocery and Grocer’s Miscellaneous Items ___ 395 Forms, Continuous: Computer Paper, Form Labels, Snap-Out Forms, and Folders for Forms ___ 400 Foundry Castings, Equipment, and Supplies ___ 405 Fuel, Oil, Grease and Lubricants ___ 410 Furniture: Health Care and Hospital Facility ___ 415 Furniture: Laboratory ___ 420 Furniture: Cafeteria, Chapel, Dormitory, Household, Library, Lounge, School ___ 425 Furniture: Office ___ 430 Gases, Containers, Equipment: Laboratory. Medical, and Welding ___ 435 Germicides, Cleaners, and Related Sanitation Products for Health Care Personnel ___ 440 Glass and Glazing Supplies ___ 445 Hand Tools (Powered and Non-Powered), Accessories and Supplies ___ 450 Hardware and Related Items ___ 460 Hose, Accessories, and Supplies: Industrial, Commercial, and Garden ___ 465 Hospital and Surgical Equipment, Instruments, and Supplies ___ 470 Hospital Equipment and Supplies: Mobility, Speech Impaired, and Restraint Items ___ 475 Hospital, Surgical, and Related Medical Accessories & Sundry Items ___ 485 Janitorial Supplies, General Line ___ 490 Laboratory Equipment and Accessories (For General Analytical and Research Use): Nuclear, Optical, and Physical ___ 493 Laboratory Equipment and Accessories: Biochemistry, Chemistry, Environmental Science, Etc. ___ 495 Laboratory and Field Equipment and Supplies: Biology, Botany, Geology, Microbiology, Zoology, Etc. ___ 500 Laundry and Dry Cleaning Equipment, Accessories, Parts and Supplies - Commercial ___ 505 Laundry and Dry Cleaning Compounds and Supplies ___ 510 Laundry Textiles and Supplies ___ 515 Lawn Maintenance Equipment, Accessories, and Parts (Non-Agricultural Applications) ___ 520 Leather and Related Equipment. Products, Accessories, & Supplies ___ 525 Library and Archival Equipment, Machines, and Supplies ___ 530 Luggage, Brief Cases, Purses and Related Items ___ 540 Lumber and Related Products ___ 545 Machinery and Hardware, Industrial ___ 550 Markers, Plaques and Traffic Control Devices ___ 555 Marking and Stenciling Devices ___ 556 Mass Transportation - Transit Bus ___ 557 Mass Transportation - Transit Bus Accessories and Parts ___ 558 Mass Transportation - Rail Vehicles and Systems ___ 559 Mass Transportation - Rail Vehicles Parts and Accessories ___ 560 Material Handling and Storage Equipment and Allied Items ___ 565 Mattress Manufacturing Machinery and Supplies ___ 570 Metals: Bars, Plates, Rods, Sheets, Strips, Structural Shapes, Tubing, and Fabricated Items ___ 575 Microfiche and Microfilm Equipment, Accessories, and Supplies ___ 578 Miscellaneous Products ___ 580 Musical Instruments, Accessories, and Supplies ___ 590 Notions and Related Sewing Accessories, and Supplies ___ 595 Nursery Stock, Equipment, and Supplies ___ 600 Office Machines, Equipment, and Accessories ___ 605 Office Mechanical Aids, Small Machines, and Apparatuses ___ 610 Office Supplies: Carbon Paper and Ribbons, All Types ___ 615 Office Supplies, General ___ 620 Office Supplies: Erasers, Inks, Leads, Pens, Pencils, Etc. ___ 625 Optical Equipment, Accessories, and Supplies ___ 630 Paint, Protective Coatings, Varnish, Wallpaper, and Related Products ___ 635 Painting Equipment and Accessories ___ 640 Paper and Plastic Products, Disposable ___ 645 Paper (For Office and Print Shop Use) ___ 650 Park, Playground, Recreational Area and Swimming Pool Equipment ___ 652 Personal Hygiene and Grooming Equipment and Supplies ___ 656 Photographic Equipment and Supplies (Not Including Graphic Arts, Microfilm, and X-Ray) ___ 658 Pipe and Tubing ___ 659 Pipe Fittings ___ 660 Pipes, Tobaccos, Smoking Accessories: Alcoholic Beverages ___ 665 Plastics, Resins, Fiberglass: Construction, Forming, Laminating, and Molding Equipment, Accessories, and Supplies ___ 670 Plumbing Equipment, Fixtures, and Supplies ___ 675 Poisons: Agricultural and Industrial ___ 680 Police Equipment and Supplies ___ 685 Poultry Equipment and Supplies ___ 690 Power Generation Equipment, Accessories, Supplies ___ 691 Power Transmission Equipment - Electrical, Mechanical Air and Hydraulic ___ 700 Printing Plant Equipment and Supplies (Except Papers) ___ 710 Prosthetic Devices, Hearing Aids, Auditory Testing Equipment, Electronic Reading Devices, Etc. ___ 715 Publications and Audiovisual Materials (Prepared Materials Only, Not Equipment, Supplies, or Production) ___ 720 Pumping Equipment and Accessories ___ 725 Radio Communication, Telephone, and Telecommunication Equipment, Accessories, and Supplies ___ 730 Radio Communication and Telecommunication Testing, Measuring, and Analyzing Equipment, Accessories and Supplies ___ 735 Rags, Shop Towels, and Wiping Cloths ___ 740 Refrigeration Equipment and Accessories ___ 745 Road and Highway Building Materials (Asphaltic) ___ 750 Road and Highway Building Materials (Not Asphaltic) ___ 755 Road and Highway Equipment and Parts: Asphalt and Concrete Handling and Processing ___ 760 Road and Highway Equipment: Earth Handling, Grading, Moving, Packing, Etc. ___ 765 Road and Highway Equipment (Except Asphalt, Concrete, and Earth Handling Equipment In Classes 755 and 760) ___ 770 Rooting ___ 775 Salt (Sodium Chloride) (See Class 393 for Table Salt) ___ 780 Scales and Weighing Apparatus (See 175-08 for Laboratory Balances) ___ 785 School Equipment and Supplies ___ 790 Seed, Sod, Soil, and Inoculants ___ 795 Sawing, Room and Textile Machinery, and Accessories ___ 800 Shoes and Boots ___ 801 Signs, Sign Materials, Sign Making Equipment, and Related Supplies ___ 803 Sound Systems, Components, and Accessories: Group Intercom, Music, Public Address, Etc. ___ 805 Sporting and Athletic Goods ___ 810 Spraying Equipment (Except Household, Nursery Plant, and Paint) ___ 815 Steam and Hot Water Fittings, Accessories, and Supplies ___ 820 Steam and Hot Water Boilers, Steam Heating, and Power Plant Equipment ___ 825 Stockman Equipment and Supplies ___ 830 Tanks (Metal, Wood, and Synthetic Materials): Mobile, Portable, Stationary, and Underground Types ___ 832 Tape (Not Data Processing, Measuring, Optical, Sawing, Sound, or Video) ___ 840 Television Equipment and Accessories ___ 845 Testing Apparatus and Instruments (Not for Electrical or Electronic Measurements) ___ 850 Textiles, Fibers, Household Linens. and Place Goods ___ 855 Theatrical Equipment and Supplies ___ 860 Tickets, Coupon Books, Sales Books, Strip Books, Etc. ___ 863 Tires and Tubes ___ 864 Train Controls, Electronic ___ 865 Twine ___ 870 Venetian Blinds, Awnings, and Shades ___ 875 Veterinary Equipment and Supplies (See Class 325 for Vitamins and Supplements for Animals) ___ 880 Visual Education Equipment and Supplies (Except Projection Lamps See Class 285) ___ 883 Voice Response Systems ___ 885 Water and Wastewater Treating Chemicals ___ 890 Water Supply and Sewage Treatment Equipment (Not for Air Conditioning, Steam Boiler, or Laboratory Reagent Water) ___ 895 Welding Equipment and Supplies ___ 898 X-Ray and Other Radiological Equipment and Supplies (Medical) ___ 905 Aircraft Operations Services ___ 906 Architectural Services, Professional ___ 907 Architectural and Engineering Services, Non-Professional ___ 908 Bookbinding, Rebinding, and Repairing ___ 909 Building Construction Services - Equipment, Furnishings, and Work Covered by Building Construction Contracts Only ___ 910 Building Maintenance and Repair Services ___ 912 Construction Services, General ___ 913 Construction Services, Heavy ___ 914 Construction Services, Trade (New Construction) ___ 915 Communications and Media Related Services ___ 918 Consulting Services ___ 920 Data Processing Services and Software ___ 924 Educational Services ___ 925 Engineering Services, Professional ___ 926 Environmental and Ecological Services ___ 928 Equipment Maintenance, Reconditioning and Repair Services for Automobiles, Trucks, Trailers, Transit Buses and Other Vehicles ___ 929 Equipment Maintenance, Reconditioning, and Repair Services - Agricultural, Heavy Industrial Equipment, and Marine Equipment ___ 931 Equipment Maintenance, Reconditioning, and Repair Services - Appliance, Athletic, Cafeteria, Furniture, Musical Instruments, and Sewing Equipment ___ 934 Equipment Maintenance, Reconditioning, and Repair Services - Laundry, Lawn, Painting, Plumbing, and Spraying Equipment ___ 936 Equipment Maintenance, Reconditioning, and Repair Services - General Equipment ___ 938 Equipment Maintenance, Reconditioning, and Repair Services - Hospital, Laboratory, and Testing Equipment ___ 939 Equipment Maintenance, Reconditioning, and Repair Services - Office, Photographic, and Radio/Television Equipment ___ 940 Equipment Maintenance, Repair, and Construction Services - Railroad ___ 941 Equipment Maintenance, Reconditioning, Repair, and Related Services - Power Generation ___ 945 Fishing, Hunting, Trapping, Game Propagation, and Related Services ___ 946 Financial Services ___ 947 Forestry Services ___ 948 Health Related Services (For Human Services See Class 952) ___ 952 Human Services ___ 953 Insurance. All Types ___ 954 Laundry and Dry Cleaning Services ___ 956 Library Services (See Class 98 for Bookbinding, Rebinding, and Repairing) ___ 958 Management Services ___ 959 Marine Construction Services-, Marine Equipment Maintenance and Repair, Related Marine Services ___ 961 Miscellaneous Professional Services ___ 962 Miscellaneous Services ___ 965 Printing Preparations: Etching, Photoengraving, and Preparation of Mats, Negatives and Plates ___ 966 Printing and Related Services ___ 968 Public Works, Construction, and Related Services ___ 971 Real Property Rental or Lease ___ 975 Rental or Lease Services of Equipment - Agricultural, Aircraft, Automotive, Heavy Equipment and Marine - Equipment ___ 977 Rental or Lease Services of Equipment - Appliances. Cafeteria, Film, Furniture, Hardware, Musical, Sewing, and Window and Floor Coverings ___ 979 Rental or Lease Services of Equipment - Engineering, Hospital, Laboratory, Precision Instruments, Refrigeration, Scales, and Testing Equipment ___ 981 Rental or Lease of Equipment - General Equipment ___ 983 Rental or Lease Services of Equipment - Janitorial, Laundry, Lawn, Painting, Spraying, and Textile Equipment ___ 984 Rental or Lease services of Computers, Data Processing and Word Processing Equipment ___ 985 Rental or Lease Services of Equipment - Office, Photographic, Printing. Radio/Television/Telephone Equipment ___ 988 Roadside, Grounds, Recreational and Park Area Services ___ 989 Sampling and Sample Preparation Services (For Testing) ___ 990 Security. Fire, Safety, and Emergency Services ___ 992 Testing and Calibration Services ___ 998 Sale of Surplus & Obsolete Items