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Vendor Profile

MuniVendor auto-fills the forms required by the local government organization to ensure that there are no errors or omissions in your submission packets. Please ensure that all the information filled out in your Vendor Profile is accurate and up to date, because MuniVendor utilizes the information you fill out below to accomplish this. If you have any questions about how to correctly fill out your Vendor Profile, please call a MuniVendor representative between 9am and 5pm EST at 732 354 XXXX or email us at vendorprofilesupport@munivendor.com requesting support.

Organization Information

The information in this section is used on many of the standard NJ State and additional forms used by local government organizations in New Jersey.

Organization Name(Required)

This should be the full legal name of your organization.

Organization Address(Required)

Street Address Address Line 2 City State ZIP Code

Date of Incorporation(Required)

When did you incorporate?

Organization Type(Required)

What type of entity is this?

Current Business Name & Address

Length of time at current address with business name.

Please enter a number from 0 to 100.

Tax ID Number (FEIN)

To acquire a Federal Tax ID Number, please visit the IRS website at https://www.irs.gov/businesses/small-businesses-self-employed/get-an-employer-identification-number and click on "Apply for an EIN".

Phone Number(Required)

Fax Number

Legal

Contract Failure

Within the last five years has the business or any officer/partner failed to complete a contract awarded to them?

Liens and/or Lawsuits

Have any liens and lawsuits been filed against the company in the past five years?

Contract Failure Details

Please provide the details pertaining to the failure(s) to complete a contract awarded.

Lien & Lawsuit Details

Please provide the details pertaining to the liens and/or lawsuits filed against your organization.

Stockholder Information

Please enter the names and addresses of all stockholders who hold 10% or more of the issued and outstanding stock of the organization. The information in this section is used to auto-fill the Stockholder Disclosure Certification form, and the Statement of Ownership Disclosure N.J.S.A. 52:2524.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43). NOTE TO DEVELOPMENT TEAM - There should be a button at the bottom of this section named "Add Additional Stockholder" that enables the vendor to add additional stockholders and their addresses.

Are there stockholders who hold 10% or more of the issued and/or outstanding stock of the organization?(Required)

Selecting "No" for this field means that no one stockholder holds 10% or more of your organization.

Stockholder Type

Stockholder Name (Person)

First Last

Stockholder Address (person)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Stockholder Name (Organization)

Enter the full legal name of the business.

Publicly Traded?

Is the stockholder listed above a publicly traded entity?

Website of Publicly Traded Stockholder's Last Annual SEC (or foreign equivalent) Filing

If a bidder has a direct or indirect parent entity which is publicly traded, and any person holds a 10 percent or greater beneficial interest in the publicly traded parent entity as of the last annual federal Security and Exchange Commission (SEC) or foreign equivalent filing, ownership disclosure can be met by providing links to the website(s) containing the last annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent) that contain the name and address of each person holding a 10% or greater beneficial interest in the publicly traded parent entity, along with the relevant page numbers of the filing(s) that contain the information on each such person.

Stockholder Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Information of the Authorizing Official

The Authorizing Official is the person who's name and signature will be entered into the forms requested by the local government organization.

Authorizing Official Name(Required)

This is the name of the person that MuniVendor will automatically enter into the forms required by the local government organization publishing the opportunity.

First Last

Authorizing Official Title

Please enter the title of the authorizing official. For example, "owner", "partner", etc.

Notarization County(Required)

Please indicate the County in which you will be present when completing digital notarization.

Address

This content enables MuniVendor to autofill several forms, including the Non-Collusion Affidavit, which is a required form for most local government organizations.

Street Address Address Line 2 City State ZIP Code

Authorized Official's Email Address(Required)

Email Address Confirm Email Address

Authorized Official's Phone(Required)

Best Time to Call You

Required Compliance Forms

Mandatory Equal Employment Opportunity Language

N.J.S.A. 10:5-31 et seq. (P.L.1975, c.127) and N.J.A.C. 17:27 et seq. Selected contractors must submit one of the documents listed below to the public agency. Please confirm which of the following your organization will submit when responding to opportunities. Form AA-302 can be downloaded at http://www.state.nj.us/treasury/contract_compliance

Letter of Federal Affirmative Action Plan Approval

Please upload your organization's Letter of Federal Affirmative Action Plan Approval.