City of Hampton - Doing Business - Bids & Contracts

Vendor Registration Application
(FIN or SSN required)

All fields marked with * are required.

*Business Name:

*Owner:

*Street Address:

*City:

*State: *Zip:

*E-mail Address:

*Phone Number:

Fax Number:

Federal Employer's ID:

Social Security Number:

NOTE: if there are any changes to the above information, you must notify the Procurement Office in writing. Failure to do so may result in the removal of your company from the City's Business Mailing List. You may also update the information by visiting our web site www.hampton.gov.

A Minority Business is any firm in which minority persons collectively own and share in earnings of 51 percent (51%) or more of the firm. Indicate the classification below which best denotes the minority status.

Please select the correct classification:

Registered Vendor Only	Minority-Owned Business
Minority/Woman-Owned Business	Woman-Owned Business

Please select your minority status:

*VA Department Minority Business Enterprise Certification Number:

Please identity equipment, supplies, material and/or services on which you wish to bid by commodity code (limit 35) from the code list:

Please specify other services you can provide which are not included in the commodity code list: