HomeMy WebLinkAbout8 Vendor Setup FormVendor Setup Form
City of Renton Finance Department
1055 South Grady Way — 5th Floor
Renton, WA 98057
www.rentonwa.gov
Instructions: Complete all sections of this form and return this form by fax (425) 430-6957, U.S. Mail or email.
Failure to submit a W-9 can create a delay in our payments to you, and your payment(s) could be subject to the
IRS required back up withholding
Name
Check Payable to if different than above
Address
City State Zip
Please check all that apply:
❑ Disadvantaged Business Enterprise
❑ Minority Business Enterprise
❑ Women Business Enterprise
Who is your contact person at the City of Renton?
City of Renton Department you are working with?
Account #
Please attach a voided check or direct deposit letter from your bank
EIN
Accounts Receivable Contact
Accounts Receivable Phone Number
Please Provide a Current W-9 form
https://www.irs.gov/pub/irs-pdf/fw9.pdf
City of Renton Business license is required by City of
Renton municipal code, Business regulation #5-5-3.
Renton Business license #
State of Washington UBI #
Questions? Contact Business Licensing at
https://rentonwa.gov/businessIicensing
Routing #
I/we hereby give the City of Renton the authority to make EFT direct deposits to the bank account described above. I/we understand that if this EFT
agreement is to be changed or canceled in any way that I/we must provide 30 day advance written notice to the City of Renton at the above
address.
Signature
Printed Name
Date
Finance Accounts Payable Team
Natalie Wissbrod, Accounting Asst. Casaundra Sauls, Accounting Asst. Jen Hughes, Finance Manager
(425) 430-6919 (425) 430-6930 (425) 430-6935
nissbrod@rentonwa.gov csauls@rentonwa.gov ihuRhes@rentonwa.Rov