Vendor Application

Business Name:  (*) = Req'd

Business Legal Name (if different):  

Your Contact at DU:

Name   (*)     Email Address    

If the name is commonly abbreviated, enter the abbreviation first, followed by the name.  For example, NAEP, the National Association of Educational Procurement.

"Order From" (Purchase Order) address:

Street Address 1      (*)

Street Address 2 

City (*)      State  (*)     Zip (*)

Phone    & Fax  (We fax most orders)

Contact Name for Orders    

Contact Phone for Orders    

Contact Email Address         

"Remit To" (A/P) address:

Check here if same as "Order From" address.

Street Address 1    

Street Address 2    

City         State         Zip    

Payment Terms     

Will you accept University Corporate Purchasing Cards? YES NO

Payments (A/R) Contact     Phone

Additional information:

1. Type of Business: (check all that apply):

Not sure? See the definitions of government business types.

2. Conflict of Interest

A conflict of interest may exist in a situation where a University of Denver employee and/or his or her spouse or emancipated minor children have a connection to the above referenced supplier, and a reasonable person would think this relationship would compromise the competitive process.

Does any individual employed by the University of Denver have a significant interest in your business? YES NO (*) 

If a conflict of interest is indicated, please complete the following section:

3. Application information provided by:

Company representative's name: (*)

Title: (*)

Email address:

4. Form submitted by, if different from information provided by:

Name:

Email address:

(*)  Indicates Field Is Required, or Form Cannot Be Submitted

Comments: