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2. This form is used by vendors expecting payment from the city for products or services rendered but are not actively seeking to be part of the bidding process.
4. Name*
   As it should appear on payment
6. DBA Name
8. Remittance Address*
10. Address2
12. City*
13. State*
14. Zip*
16. Mailing Address*
18. Address2
20. City*
21. State*
22. Zip*
24. A/R Contact
25. Email Address*
27. Phone Number*
28. Fax Number
30. Sales Representative
31. Email Address*
33. Phone Number
34. Fax Number
36. Tax ID # or Social Security #*
    Which ever is applicable
37. Discount if offered, terms
39. Attach Completed W-9*
40. Blank W-9 Form
    W-9

    *Effective Friday, November 9, 2018 the City of North Richland Hills will accept only the new version (revised date: October 2018) of Form W-9. The revised date is printed at the top left part of every page. We will reject previous editions of this form if you submit them on or after November 9.
42. ACH Payment Request Form
    Form

    As of October 7, 2010 ACH payments were implemented to ensure invoices are paid in a timely manner which has resulted in physical checks being issued BI-WEEKLY only. To receive future payments by ACH, which are done weekly, please follow the Form link to sign up.
44. Have you signed up for ACH payments (above) as part of this vendor registration?*
    -- Select One --YESNO
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit Submit and Print

* indicates a required field