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Vendor Application 

To be placed on the Vendor's List, please contact the Purchasing Department by calling (517)483-1785,  send a written request to the following address, download the Application and mail or fill out the form below: 

7130 - Purchasing Department
Lansing Community College
PO Box 40010
Lansing, MI 48901-7210

Name of Company:
 
Address where Bidding Forms/Purchase Orders are to be mailed:
 
Address Payments to be mailed Street No., City, State, Zip Code:
 
Phone:
Fax:
 
Website Address: 
 
Email Address: 
 
Parent Company (& Addt'l Office Locations in Michigan):
 
Federal ID Number:    
  OR
Social Security Number: 

If you prefer not to submit your SS # online, please print form and fax to 517-483-5289 or call Purchasing at 517-483-1785 with your SS #. Thank You

 
Type of Organization:

Individual
Partnership
Corporation

 

Do you accept? (check all that apply)

Procurement Cards
Electronic Disk Catalog
Electronic Ordering

 
Dun & Bradstreet Rating (if available) 
 
Persons to Contact and Those Authorized to Sign Bids & Contracts in Your Name (if agent, so specify)
Please list Name, Official Capacity and Telephone Number:

    
 
Do you require a hard copy of verbal orders?

Yes
No

 

Select the category which applies to the applicant:

(A) Manufacturer or Producer
(B) Wholesaler
(C) Retailer
(D) Manufacturer's Agent
(E) Distributor
(F) Service Establishment

 

PLEASE COMPLETE BELOW:

Please list percentage and choose category that applies:

Minority Owned Percentage:    
Minority Owned: 

Women Owned Percentage: 
Women Owned: 

Disabled:  %

Are you certified?  If so, list agencies

Certificate Number:

 

Small Business:  Yes         No

Business located within Lansing Community College District:   Yes
No
 

Please complete the following:

Standard Payment Terms:

Prompt Pay Discount:  
FOB Point:  
Standard Delivery Time: 
Signature of Person Authorized to Sign this Application (Please Type Name)
Name and Title of Person Signing (Please Type Name and Title)

Please place a checkmark ✓ by the appropriate code and provide a detailed description of the commodities and/or services offered.  If the complete NAICS Code is known please include this number in the description area.  Website URL address for NAICS is:   http://www.census.gov/epcd/www/naics.html

 
(11) Agriculture, Forestry, Fishing & Hunting
(21) Mining
(22) Utilities
(23) Construction
(31-33) Manufacturing
(42) Wholesale Trade
(44-45) Retail Trade
(48-49) Transportation & Warehousing
(51) Information
(52) Finance & Insurance
(53) Real Estate, Rental & Leasing
(54) Professional, Scientific & Technical Services
(55) Management of Companies and Enterprises
(56) Administrative & Support, Waste Management & Remediation Services
(61) Educational Services
(62) Health Care & Social Assistance
(71) Arts, Entertainment & Recreation
(72) Accommodation and Food Services
(81) Other Services (except Public Administration)
(92) Public Administration
(99) Unclassified Establishments
 

Detailed Description:

 


Purchasing Department at Lansing Community College

Purchasing Department
Washington Court Place, Room 214
Phone: (517) 483-1785
Additional contact information »