Goodwill SWPA - Vendor Form

Vendor Form

Thank you for your interest in becoming a vendor with Goodwill of Southwestern Pennsylvania. Goodwill is committed to diversity and believes in providing equal opportunity for all Suppliers while developing and advocating a diversified Supplier base, otherwise known as Minority-, Women-, Persons with Disabilities-, Service Disable-, and Vietnam Era Veteran-owned Business Enterprises (MWDVBEs).

Goodwill makes every effort to utilize MWDVBE firms to the fullest extent possible. Goodwill is also committed to establishing relationships with other suppliers who share its vision and dedication to the principles set forth in its policy regarding MWDVBEs.

Click here to learn about ethical practices for vendors at Goodwill.

Please submit the following information:

* 1.) Have you done business with Goodwill of Southwestern Pennsylvania in the past?

Yes

* 2.) Please select the category that best describes your business:

Building Maintenance (including Construction)

Building Supplies (including Fixtures and Equipment)

Food Service/Restaurant Industry

General/Office Supplies

Janitorial Equipment and Supplies

Printing Services

Retail Goods

Transportation

Other :

* 3.) COMPANY INFORMATION
Company Name

* Phone Number

Fax Number

Website

* Country

* Street Address

* City

* State (Region)

* Postal Code

* 4.) COMPANY CONTACT
General Business Contact First Name

* Last Name

* Phone Number

* Email address

5.) MAILING ADDRESS (if different)
Country

Street Address

City

State (Region)

Postal Code

7.) BUSINESS TYPE (D&B Number)

* 8.) Please select one of the following business types. If your business does not meet the following criteria (the company must be at least 51% owned, controlled and actively managed by an individual or individuals of MWDVBE), please select "None of the above."

Minority Business Enterprise (MBE)

Women Business Enterprise (WBE)

Disadvantaged Business Enterprise (DSV)

Disabled Veteran Enterprise (DIS)

Veteran Business Enterprise (VBE)

None of the above

* 9.) Please indicate how your company is being managed. If your business does not meet the following criteria, please select "None of the above."

The company is at least 51% owned, controlled and operated by one or more U.S. Citizens included in the diversity groups selected above

The company is not at least 51% owned by one or more members of a diversity group, but is at least 51% controlled and operated by one or more U.S. Citizens included in the diversity groups selected above

None of the above

* 10.) Does your company hold any government and diversity certifications?

Yes (if "yes," please proceed to Question 11)

No (if "no," please proceed to Question 12)

11.) If you answered "Yes" in Question 10, please indicate all certifications your company holds. In addition, please provide all certification information.

DGS-Certifications with the State of PA

DOT, State, City and Other Diversity Certifications - Certifications and/or Registrations with another certifying agency

U.S. Small Business Administration (Federal) - Certifications and/or Registrations with the U.S. Small Business Administration

NMSDC Certifications - Certification with a National Minority Supplier Development Council or local affiliate (NMSDC)

WBENC Certifications - Certification with a Women's Business Enterprise National Council (WBENC)

Certifying Agency Name

Certification Name

Certification Number

Certification Expiration Date

* 12.) PRODUCT AND SERVICE DESCRIPTIONS
Please provide a brief description of your company's products and services:

Please note that Goodwill of Southwestern Pennsylvania’s payment terms are net 45 days.

* required