Vendor Application

Please fill out if you would like to be considered as an approved vendor for JPUD. Must be renewed annually.

Business Address
Mailing Address(Required)
Contact Name(Required)
Business Type
Corporation, Sole Proprietorship, Partnership, etc..

Vendor Type
Please Check All That Apply
Utilities Served
Products Types
please list any additional relevant product categories offered by your business. Unique Entity Identification Number
Qualified Disadvantaged Business Enterprise ?(Required)
Is your Business Registered as a Qualified Disadvantaged Business Enterprise (small, minority and/or women owned business)?
American Made?(Required)
Does your business offer American made goods produced and/or manufactured in the United States
Summary of manufacturer's product lines represented by this agency in pdf format (if applicable)
Accepted file types: pdf, jpg, Max. file size: 15 MB.
Please upload a completed W9 in pdf format
Accepted file types: pdf, jpg, Max. file size: 15 MB.
This field is for validation purposes and should be left unchanged.