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2. Procurement Code
   The City of North Miami Procurement Code describes the rules and regulations used in the operation of the Purchasing Department and is available for review online on the Municode Website.
4. Prohibition on Use of Expanded Polystyrene and Single-Use Plastic Beverage Straws
   Pursuant to Section 7-201 of the Procurement Code, City contractors and special event permittees shall not sell, use, provide in, or offer the use of expanded polystyrene food service articles or single-use plastic beverage straws in City facilities or on City properties. City contractors shall not sell or use expanded polystyrene or single-use plastic beverage straws within the City or while completing their duties to the City under contract. A violation of this section shall be deemed a default under the terms of the City contract, lease or concession agreement and is grounds for revocation of a special event permit. This section shall not apply to expanded polystyrene food service articles or single-use plastic beverage straws used for prepackaged food that have been filled and sealed prior to receipt by the City contractor or special event permittee.
6. Vendor Information
8. Business Name*
9. Today's Date
   Today's Date
11. Contact Person Name*
12. Contact Person Title
14. Contact Phone Number*
15. Alternate Phone Number
17. Fax Number
18. E-Mail Address*
20. Website
22. Mailing Address*
24. City*
25. State*
26. Zip Code*
28. Remit to Address
30. City
31. State
32. Zip Code
34. Purchase Orders
36. Indicate which method(s) you prefer to have purchase orders delivered

    1. E-Mail

    1. Fax
38. Email
39. Fax Number
41. Local Vendor Minority Business Survey
43. The City of North Miami tracks the status of local and minority businesses. Please check the box(es) below to indicate the applicable status of your business:

    1. African American Owned Business
    2. Asian American Owned Business
    3. Hispanic American Owned Business
    4. LGBTQIA
    5. Local North Miami Business

    1. Native American Owned Business
    2. Small Business Enterprise
    3. Woman Owned Business
    4. Other:
45. Other
47. Services/Commodities Provided
49. Indicate what types of services your company provides by providing the respective commodity codes. Please refer to the Commodity Code listing available on the Purchasing Department website.
51. Additional Information
53. Vendor Disclosure - Have any of the Owners or Officers of the Vendor seeking registration been an employee of the City of North Miami within the last two (2) years:*

    1. No
    2. Yes - Provide explanation
55. Yes - Provide explanation
57. Authorized Company Representative
59. Provide the following information for a company representative who is authorized to sign bids, offers, and contracts:
61. Name*
62. Title*
64. Phone Number*
65. Fax Number
67. Email Address*
69. Local Government Prompt Payment Act
    Payments made by City of North Miami are governed by the Local Government Prompt Payment Act (Sections 218.70 through 218.80 of the Florida Statutes) and in accordance with the City’s policies and procedures.
71. W-9 Form
    The Internal Revenue Service (IRS) requires that the City have on file a completed W-9 for all vendors. Please complete the IRS W-9 Form and submit it to the City along with this Vendor Registration Form.
73. W-9 Form*
    Submit a completed IRS form.
75. Acknowledgement
    The vendor submitting this Vendor Registration form acknowledges that they have read and agree to abide by the City of North Miami (City) Procurement Code and have also reviewed the City’s Vendor Guide. The vendor further acknowledges that no conflict of interest exists nor will any conflict of interest be created by becoming a registered vendor and/or contracting with the City.
77. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
79. Electronic Signature*
80. Date*
    Date
82. Authorized Representative Name (Print)*
83. Authorized Representative Title*
85. Contact Us
    If you have any questions filling out this form please email the Purchasing Department or call at 305-895-9886.
Leave This Blank:


87. 1. Receive an email copy of this form.
88. Email address

    This field is not part of the form submission.

89. Submit

* indicates a required field