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Vendor Application

  1. VILLAGE OF SKOKIE VENDOR APPLICATION FORM

  2. VILLAGE OF SKOKIE PURCHASING DIVISION

  3. 5127 Oakton Street

  4. Skokie, Illinois 60077

  5. (847)933-8240 Fax: (847)568-8840

  6. INSTRUCTIONS: In order to be placed on the Village of Skokie Vendor List, please respond to all required questions, and sign in the space provided. If the appropriate answer is "same", "not applicable", or "none", please write this to indicate no questions have been overlooked.

  7. 1. CONTACT INFORMATION

    Name of business, street address (no P.O. Box), City, State and Zip Code:

  8. 2. BUSINESS ORGANIZATION:

    Please check the appropriate form of business organization below.

  9. Organization*

    Corporation Sole Proprietor Individual Partnership

  10. Please list names of corporate officers and Directors (for Corporation)

  11. Please provide Taxpayer Identification Number (FEIN): (Use Social Security Number if a Sole Proprietor).

  12. 3. FINANCIAL INFORMATION:

  13. Bank Reference:

  14. 4. REFERENCES: Please provide the name of at least three (3) references for your firm (use additional sheets if necessary).

  15. The undersigned certifies to the following: 1. The undersigned is authorized to sign this form on behalf of the applicant. 2. All information shown on this form is correct.

  16. Leave This Blank:

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