Public Entity Registration

Public Entity Name (Value Required)

Website

Tax ID

Tax ID Type (Value Required)

FEIN

Office Type (Branch requires DUNS) (Value Required)

Branch

DUNS Number (No Hyphens or Dashes)

Tax Id Help

Fields above are required if Tax ID is entered.

Info

Please use the legal name of the entity associated with the Tax ID. In order to be awarded a contract or receive payment, the information in the County’s financial system must match the data provided here. Your W-9 form must also match the data provided here.

W-9 Form (Value Required)

Address Line 1 (Value Required)

Address Line 2

City (Value Required)

State (Value Required)

Zip Code (Value Required)

Time Zone (Value Required)

Email Address (Value Required)

Phone (Value Required)

Extension

Fax

Title

First Name (Value Required)

Last Name (Value Required)

Middle Initial

Suffix

Position (Value Required)

Email (This will be the Username) (Value Required)

Phone (Value Required)

Extension

Fax

Contact Address Information is the same as Public Entity Address Information

Address Line 1 (Value Required)

Address Line 2 (Value Required)

City (Value Required)

State (Value Required)

Zip Code (Value Required)

New Public Entity Registration

Public Entity Information

Tax ID

Info

Public Entity Address Information

Contact Information / Account Setup

Contact Address Information