Santa Cruz County Government - General Services Department
701 Ocean Street, Room 330, Santa Cruz, CA 95060-4073

Vendor Application Form

Please complete and mail
W-9 Form (PDF Format)
after submitting the following application form.

Vendor ID:  Not Assigned

Company Name: 
(as it appears on W-9)

Date Prepared: 
Business Address:  Specify type of ownership and check below, if applicable:
City:    State:    Zip Code:    Disabled/Handicapped owned Business
Minority/Small Business
Woman-owned Business
Remit Address: 
City:    State:   Zip Code:   
 
 
Contacts:

Name Title Telephone Fax Email License #
 
 
Commodities:    

 
Entered By Name:    Title: