Erie County
Water Authority
Providing Water You Can Trust

      Emergencies (After 5pm): 716-684-0900 Customer Service/Emergencies (M-F 8 am - 5 pm): 716-849-8444

Vendor List Application

Please enter all of the information on the following form, and click submit
Name and Mailing Address for Bid Requests and Purchase Orders

Name:
Address:
City: State: Zip Code:
Country:
Contact Person:

Products or Services Offered

 

Name and Mailing Address for Payments

Name:
Address:
City: State: Zip Code:
Country:
Contact Person:

Business Information

Phone Number:  Fax Number:
Web Site:
E-Mail Address:
Place of Business:
Type Of Business:
Federal ID # (EIN): or Social Security #:

Are Vendor Payments Reportable?

Vendor Payments ARE Reportable to the IRS on Form 1099-Misc.:
Yes No

Minority Business

Certified Minority Business Classified as:
Recieved Minority Certification From:

Submit Form
By clicking SUBMIT I Hereby Certify That The Information Supplied Herein is Correct.








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