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Supplier Data Form May 2018Supplier Data Form Arial,Italic" 2Complete this form and submit to Purchasing SUPPLIER NAME: SUPPLIER ADDRESS FOR PURCHASE ORDERS: CONTACT EMAIL: ADDITIONAL CONTACT NAME: CONTACT NAME: ADDITIONAL CONTACT PHONE NUMBER: CONTACT PHONE NUMBER: CONTACT FAX NUMBER: ADDITIONAL CONTACT FAX NUMBER: ADDITIONAL CONTACT EMAIL: SUPPLIER ADDRESS FOR PAYMENT (REMIT TO): CITY, STATE, ZIP ADDRESS LINE 1 ADDRESS LINE 2 PREFERRED PAYMENT METHOD: TAXPAYER ID #: DUNS NUMBER: 1099 REPORTABLE?: INCOME TAX TYPE: MINORITY STATUS MBE: MBE TYPE: WBE: CERTIFYING AGENCY, IF KNOWN: REQUESTOR: ADDITIONAL INFORMATION OR COMMENTS: CHECK ELECTRONIC MISC1 - RENT MISC3 - OTHER INCOME MISC6 - MEDICAL & HEALTH CARE PAYMENTS MISC7 - NON-EMPLOYEE COMPENSATION MISC14 - GROSS PROCEEDS PAID TO AN ATTORNEY ü AFRICAN AMERICAN ASIAN AMERICAN HISPANIC AMERICAN NO YES SUPPLIER MANUFACTURER SUPPLIER TYPE: DEVELOPER CONSULTANT EMPLOYEE CONTRACTOR CAPITAL CONSTRUCTION EMPLOYEE #: PREFERRED COMMUNICATION METHOD FOR PURCHASE ORDERS: FOR PURCHASING USE ONLY: DATE SUPPLIER CREATED: SUPPLIER #: CREATED BY: FAX - # EMAIL: REQUESTOR PHONE #: RETURN THIS FORM TO: SUPPLIERS@STLMSD.COM SUPPLIER DATA FORM LIST PRODUCT AND SERVICES CODES AS APPLIES BELOW: EASEMENT TEMPORARY/PERMANENT NEW/OLD PROJECT EMERGENCY REQUEST REASON (MUST BE FILLED IN) IF YES, CHECK THE BOX TO THE RIGHT Supplier Work Categories CATEGORY CODE DESCRIPTION ITEMS: 005.00 ABRASIVES 010.00 ACOUSTICAL TILE, INSULATING MATERIALS, AND SUPPLIES 015.00 ADDRESSING, COPYING, MIMEOGRAPH, AND SPIRIT DUPLICATING MACHINES AND SUPPLIES 010.11 ADHESIVES AND CEMENTS, ACOUSTICAL TILE ADHESIVES AND CEMENTS, INSULATION 025.00 AIR COMPRESSORS AND ACCESSORIES 031.00 AIR CONDITIONING, HEATING, AND VENTILATING: EQUIPMENT, PARTS 045.00 APPLIANCES AND EQUIPMENT, HOUSEHOLD TYPE 055.00 AUTOMOTIVE ACCESSORIES FOR AUTOMOBILES, BUSES, TRUCKS, ETC. 065.00 AUTOMOTIVE BODIES, ACCESSORIES, AND PARTS 060.00 AUTOMOTIVE MAINTENANCE ITEMS AND REPAIR/REPLACEMENT PARTS 075.00 AUTOMOTIVE SHOP EQUIPMENT AND SUPPLIES 070.00 AUTOMOTIVE VEHICLES AND RELATED TRANSPORTATION EQUIPMENT 080.00 BADGES, EMBLEMS, NAME TAGS AND PLATES, JEWELRY, ETC. 085.00 BAGS, BAGGING, TIES, AND EROSION CONTROL EQUIPMENT 100.00 BARRELS, DRUMS, KEGS, AND CONTAINERS 105.00 BEARINGS (EXCEPT WHEEL BEARINGS AND SEALS -SEE CLASS 060) 110.00 BELTS AND BELTING: CONVEYOR, ELEVATOR, POWER TRANSMISSION, A 115.00 BIOCHEMICALS, RESEARCH 125.00 BOOKBINDING SUPPLIES, ADHESIVES, PASTES, ETC 908.00 BOOKBINDING, REBINDING, AND REPAIRING 135.00 BRICKS AND OTHER CLAY PRODUCTS, REFRACTORY MATERIALS, AND ST 140.00 BROOM, BRUSH, AND MOP MANUFACTURING MACHINERY AND SUPPLIES 145.00 BRUSHES (ALL) 150.00 BUILDER'S SUPPLIES (ALL) 155.00 BUILDINGS AND STRUCTURES: FABRICATED AND PREFABRICATED 175.00 CHEMICAL LABORATORY EQUIPMENT AND SUPPLIES 180.00 CHEMICAL RAW MATERIALS (IN LARGE QUANTITIES PRIMARILY FOR MA 190.00 CHEMICALS AND SOLVENTS, COMMERCIAL (ALL) 192.00 CLEANING COMPOSITIONS, DETERGENTS, SOLVENTS, AND STRIPPERS - 193.00 CLINICAL LABORATORY REAGENTS AND TESTS (BLOOD GROUPING, DIAG 195.00 CLOCKS, TIMERS, WATCHES, AND JEWELERS' AND WATCHMAKERS' TOOL 200.00 CLOTHING, APPAREL, UNIFORMS, AND ACCESSORIES 915.00 COMMUNICATIONS AND MEDIA RELATED SERVICES 207.00 COMPUTER ACCESSORIES AND SUPPLIES 204.00 COMPUTER HARDWARE AND PERIPHERALS FOR MICROCOMPUTERS 206.00 COMPUTER HARDWARE AND PERIPHERALS FOR MINI AND MAIN FRAME CO 208.00 COMPUTER SOFTWARE FOR MICROCOMPUTERS (PREPROGRAMMED) 209.00 COMPUTER SOFTWARE FOR MINI AND MAINFRAME COMPUTERS (PREPROGR 210.00 CONCRETE AND METAL CULVERTS, PILINGS, SEPTIC TANKS, ACCESSOR 220.00 CONTROLLING, INDICATING, MEASURING, MONITORING, AND RECORDIN 225.00 COOLERS, DRINKING WATER (WATER FOUNTAINS) 578.20 COUNTERS, MECHANICAL: TALLY, ETC. 578.22 COUNTING MACHINES, ELECTRONIC (NOT TICOMETERS, SEE CLASS 600 232.00 CRAFTS, GENERAL - ALL 233.00 CRAFTS, SPECIALIZED 250.00 DATA PROCESSING CARDS AND PAPER 255.00 DECALS AND STAMPS 578.27 DEHYDRATING MACHINES AND PARTS 578.28 DEODORANT SPRAY, (HEAVY DUTY OUTDOOR TYPE) 578.31 DISPLAY AND SHOWROOM EQUIPMENT AND SUPPLIES 265.00 DRAPERIES, CURTAINS, AND UPHOLSTERY MATERIAL 992.36 DRILLING, CORE TESTING & SAMPLES 269.00 DRUG AND PHARMACEUTICALS 270.00 DRUGS, PHARMACEUTICALS AND BIOLOGICALS 271.00 DRUGS, PHARMACEUTICALS, AND SETS 280.00 ELECTRICAL CABLES AND WIRES (NOT ELECTRONIC) 285.00 ELECTRICAL EQUIPMENT AND SUPPLIES (EXCEPT CABLE AND WIRE) 287.00 ELECTRONIC COMPONENTS, REPLACEMENT PARTS, AND ACCESSORIES: A 295.00 ELEVATORS AND ESCALATORS, BUILDING TYPE 290.00 ENERGY COLLECTING EQUIPMENT AND ACCESSORIES: SOLAR AND WIND 305.00 ENGINEERING EQUIPMENT, SURVEYING EQUIPMENT, DRAWING INSTRUME 310.00 ENVELOPES, PLAIN OR PRINTED - ALL 315.00 EPOXY BASED FORMULATIONS FOR ADHESIVES, COATINGS, AND RELATE 941.00 EQUIPMENT & MAINTENANCE HVAC 320.00 FASTENING, PACKAGING, STRAPPING, TYING EQUIPMENT AND SUPPLIE 330.00 FENCING 335.00 FERTILIZERS AND SOIL CONDITIONERS 340.00 FIRE PROTECTION EQUIPMENT AND SUPPLIES 345.00 FIRST AID AND SAFETY EQUIPMENT AND SUPPLIES (EXCEPT NUCLEAR 350.00 FLAGS, FLAG POLES, BANNERS, AND ACCESSORIES 578.37 FLOOD CONTROL DEVICES, EQUIPMENT, ACCESSORIES AND PARTS 360.00 FLOOR COVERING, FLOOR COVERING INSTALLATION AND REMOVAL EQUI 365.00 FLOOR MAINTENANCE MACHINES, PARTS, AND ACCESSORIES 395.00 FORMS, CONTINUOUS: COMPUTER PAPER, FORM LABELS, SNAP-OUT FOR 400.00 FOUNDRY CASTINGS, EQUIPMENT, AND SUPPLIES 405.00 FUEL, OIL, GREASE AND LUBRICANTS 420.00 FURNITURE: CAFETERIA, CHAPEL, DORMITORY, HOUSEHOLD, LIBRARY, 410.00 FURNITURE: HEALTH CARE AND HOSPITAL FACILITY 415.00 FURNITURE: LABORATORY 425.00 FURNITURE: OFFICE 430.00 GASES, CONTAINERS, EQUIPMENT: LABORATORY, MEDICAL, AND WELDI 435.00 GERMICIDES, CLEANERS, AND RELATED SANITATION PRODUCTS FOR HE 440.00 GLASS AND GLAZING SUPPLIES 445.00 HAND TOOLS (POWERED AND NON-POWERED), ACCESSORIES AND SUPPLI 450.00 HARDWARE AND RELATED ITEMS 578.50 HOLDERS, METAL: CARD, DOOR NAME CARD, LABEL, ETC. 460.00 HOSE, ACCESSORIES, AND SUPPLIES: INDUSTRIAL, COMMERCIAL, AND 465.00 HOSPITAL AND SURGICAL EQUIPMENT, INSTRUMENTS, AND SUPPLIES 470.00 HOSPITAL EQUIPMENT AND SUPPLIES: MOBILITY, SPEECH IMPAIRED, 475.00 HOSPITAL, SURGICAL, AND RELATED MEDICAL ACCESSORIES AND SUND 953.00 INSURANCE, ALL TYPES 485.00 JANITORIAL SUPPLIES, GENERAL LINE 495.00 LABORATORY AND FIELD EQUIPMENT AND SUPPLIES: BIOLOGY, BOTANY 490.00 LABORATORY EQUIPMENT AND ACCESSORIES (FOR GENERAL ANALYTICAL 505.00 LAUNDRY AND DRY CLEANING COMPOUNDS AND SUPPLIES 500.00 LAUNDRY AND DRY CLEANING EQUIPMENT, ACCESSORIES, PARTS AND S 510.00 LAUNDRY TEXTILES AND SUPPLIES 515.00 LAWN MAINTENANCE EQUIPMENT, ACCESSORIES, AND PARTS (NON-AGRI 520.00 LEATHER AND RELATED EQUIPMENT, PRODUCTS, ACCESSORIES, AND SU 525.00 LIBRARY AND ARCHIVAL EQUIPMENT, MACHINES, AND SUPPLIES 530.00 LUGGAGE, BRIEF CASES, PURSES AND RELATED ITEMS 540.00 LUMBER AND RELATED PRODUCTS 545.00 MACHINERY AND HARDWARE, INDUSTRIAL 550.00 MARKERS, PLAQUES AND TRAFFIC CONTROL DEVICES 555.00 MARKING AND STENCILING DEVICES 560.00 MATERIAL HANDLING AND STORAGE EQUIPMENT AND ALLIED ITEMS 578.55 MATS, ALL KINDS (NOT OTHERWISE CLASSIFIED) 565.00 MATTRESS MANUFACTURING MACHINERY AND SUPPLIES 570.00 METALS: BARS, PLATES, RODS, SHEETS, STRIPS, STRUCTURAL SHAPE 575.00 MICROFICHE AND MICROFILM EQUIPMENT, ACCESSORIES, AND SUPPLIE 578.00 MISCELLANEOUS PRODUCTS 600.00 OFFICE MACHINES, EQUIPMENT, AND ACCESSORIES 605.00 OFFICE MECHANICAL AIDS, SMALL MACHINES, AND APPARATUSES 615.00 OFFICE SUPPLIES, GENERAL 610.00 OFFICE SUPPLIES: CARBON PAPER AND RIBBONS, ALL TYPES 620.00 OFFICE SUPPLIES: ERASERS, INKS, LEADS, PENS, PENCILS, ETC. 625.00 OPTICAL EQUIPMENT, ACCESSORIES, AND SUPPLIES 630.00 PAINT, PROTECTIVE COATINGS, VARNISH, WALLPAPER, AND RELATED 635.00 PAINTING EQUIPMENT AND ACCESSORIES 645.00 PAPER (FOR OFFICE AND PRINT SHOP USE) 640.00 PAPER AND PLASTIC PRODUCTS, DISPOSABLE 655.00 PHOTOGRAPHIC EQUIPMENT AND SUPPLIES (NOT INCLUDING GRAPHIC A 658.00 PIPE AND TUBING 659.00 PIPE FITTINGS 665.00 PLASTICS, RESINS, FIBERGLASS: CONSTRUCTION, FORMING, LAMINAT 670.00 PLUMBING EQUIPMENT, FIXTURES, AND SUPPLIES 578.59 PNEUMATIC TUBE EQUIPMENT, ACCESSORIES, AND SUPPLIES 675.00 POISONS: AGRICULTURAL AND INDUSTRIAL 700.00 PRINTING PLANT EQUIPMENT AND SUPPLIES (EXCEPT PAPERS) 715.00 PUBLICATIONS AND AUDIOVISUAL MATERIALS (PREPARED MATERIALS O 720.00 PUMPING EQUIPMENT AND ACCESSORIES 730.00 RADIO COMMUNICATION AND TELECOMMUNICATION TESTING, MEASURING 725.00 RADIO COMMUNICATION, TELEPHONE, AND TELECOMMUNICATION EQUIPM 735.00 RAGS, SHOP TOWELS, AND WIPING CLOTHS 578.63 REAL ESTATE: LAND AND IMPROVEMENTS 578.64 RECYCLING EQUIPMENT, MACHINES, AND SUPPLIES 740.00 REFRIGERATION EQUIPMENT AND ACCESSORIES 745.00 ROAD AND HIGHWAY BUILDING MATERIALS (ASPHALTIC) 750.00 ROAD AND HIGHWAY BUILDING MATERIALS (NOT ASPHALTIC) 765.00 ROAD AND HIGHWAY EQUIPMENT (EXCEPT ASPHALT, CONCRETE, AND EA 755.00 ROAD AND HIGHWAY EQUIPMENT AND PARTS: ASPHALT AND CONCRETE H 760.00 ROAD AND HIGHWAY EQUIPMENT: EARTH HANDLING, GRADING, MOVING, 998.00 SALE OF SURPLUS & OBSOLETE ITEMS 775.00 SALT (SODIUM CHLORIDE) (SEE CLASS 393 FOR TABLE SALT) 780.00 SCALES AND WEIGHING APPARATUS 790.00 SEED, SOD, SOIL, AND INOCULANTS 800.00 SHOES AND BOOTS 801.00 SIGNS, SIGN MATERIALS, SIGN MAKING EQUIPMENT, AND RELATED SU 803.00 SOUND SYSTEMS, COMPONENTS, AND ACCESSORIES: GROUP INTERCOM, 810.00 SPRAYING EQUIPMENT (EXCEPT HOUSEHOLD, NURSERY PLANT, AND PAI 820.00 STEAM AND HOT WATER BOILERS, STEAM HEATING, AND POWER PLANT 815.00 STEAM AND HOT WATER FITTINGS, ACCESSORIES, AND SUPPLIES 005.84 STEEL WOOL 825.00 STOCKMAN EQUIPMENT AND SUPPLIES 578.85 TACHISTOSCOPIC DEVICES 578.86 TAGS, KEY (ALL KINDS) 830.00 TANKS (METAL, WOOD, AND SYNTHETIC MATERIALS): MOBILE, PORTAB 832.00 TAPE (NOT DATA PROCESSING, MEASURING, OPTICAL, SEWING, SOUND 840.00 TELEVISION EQUIPMENT AND ACCESSORIES 845.00 TESTING APPARATUS AND INSTRUMENTS (NOT FOR ELECTRICAL OR ELE 578.91 TESTING MACHINES, DRIVER, AUTOMATED (INCLUDING DRIVER SIMULA 850.00 TEXTILES, FIBERS, HOUSEHOLD LINENS, AND PIECE GOODS 863.00 TIRES AND TUBES 934.84 TOILETS, PORTABLE (INCLUDING SERVICING) 578.94 TURF, ARTIFICIAL, INDOOR AND OUTDOOR 865.00 TWINE 870.00 VENETIAN BLINDS, AWNINGS, AND SHADES 880.00 VISUAL EDUCATION EQUIPMENT AND SUPPLIES (EXCEPT PROJECTION L 885.00 WATER AND WASTEWATER TREATING CHEMICALS 890.00 WATER SUPPLY AND SEWAGE TREATMENT EQUIPMENT (NOT FOR AIR CON 895.00 WELDING EQUIPMENT AND SUPPLIES 898.00 X-RAY AND OTHER RADIOLOGICAL EQUIPMENT AND SUPPLIES (MEDICAL SERVICES: 990.05 ALARM SERVICES 906.00 ARCHITECT AND OTHER PROFESSIONAL DESIGN SERVICES (FOR CONSTR 909.00 BUILDING CONSTRUCTION SERVICES - EQUIPMENT, FURNISHINGS, AND 910.00 BUILDING MAINTENANCE AND REPAIR SERVICES 997.05 CONCRETE CONSTRUCTION 909.24 CONCRETE CONSTRUCTION SERVICES 913.46 CONSTRUCTION, SEWER AND STORM DRAON - CITY 913.47 CONSTRUCTION, SIDEWALK AND DRIVEWAY (INCL. PEDESTRIAN AND HA 913.56 CONSTRUCTION, UTILITY 913.57 CONSTRUCTION, VAULTED SIDEWALK 913.58 CONSTRUCTION, VIADUCT (INCL. RECONSTRUCTION) 913.60 CONSTRUCTION, WATER SYSTEMS, MAIN AND SERVICE LINE 913.45 CONSTRUCTION. SEWER AND STORM DRAIN - COUNTY 918.00 CONSULTING SERVICES 920.00 DATA PROCESSING SERVICES AND SOFTWARE 924.00 EDUCATIONAL SERVICES 925.00 ENGINEERING SERVICES, PROFESSIONAL 928.00 EQUIPMENT MAINTENANCE, RECONDITIONING AND REPAIR SERVICES FO 939.00 EQUIPMENT MAINTENANCE, RECONDITIONING, AND REPAIR SERVICES - OFFICE EQUIPMENT 929.00 EQUIPMENT MAINTENANCE, RECONDITIONING, AND REPAIR SERVICES: HEAVY EQUIPMENT 934.00 EQUIPMENT MAINTENANCE, RECONDITIONING, AND REPAIR SERVICES: IRRIGATION SYSTEMS 938.00 EQUIPMENT MAINTENANCE, RECONDITIONING, AND REPAIR SERVICES: LABORATORY EQUIPMENT 940.00 EQUIPMENT MAINTENANCE, REPAIR, AND CONSTRUCTION SERVICES - R 946.00 FINANCIAL SERVICES 948.00 HEALTH RELATED SERVICES 918.73 LANDSCAPING 954.00 LAUNDRY AND DRY CLEANING SERVICES 962.00 MISCELLANEOUS SERVICES 964.00 PERSONNEL, TEMPORARY (EMPLOYMENT AGENCY SERVICES) 966.00 PRINTING AND RELATED SERVICES 965.00 PRINTING PREPARATIONS: ETCHING, PHOTOENGRAVING, AND PREPARAT 968.00 PUBLIC WORKS, CONSTRUCTION, AND RELATED SERVICES 971.00 REAL PROPERTY RENTAL OR LEASE 981.00 RENTAL OR LEASE OF EQUIPMENT - GENERAL EQUIPMENT 975.00 RENTAL OR LEASE SERVICES OF EQUIPMENT - AGRICULTURAL, AIRCRA 977.00 RENTAL OR LEASE SERVICES OF EQUIPMENT - APPLIANCES, CAFETERI 979.00 RENTAL OR LEASE SERVICES OF EQUIPMENT - ENGINEERING, HOSPITA 983.00 RENTAL OR LEASE SERVICES OF EQUIPMENT - JANITORIAL, LAUNDRY, 985.00 RENTAL OR LEASE SERVICES OF EQUIPMENT - OFFICE, PHOTOGRAPHIC 988.00 ROADSIDE, GROUNDS, RECREATIONAL AND PARK AREA SERVICES 770.00 ROOFING 990.00 SECURITY, FIRE, SAFETY, AND EMERGENCY SERVICES 968.76 STREET RECONSTRUCTION 997.07 TRENCHLESS SEWER CONSTRUCTION OTHER - NOT LISTED (WRITE IN): Please see second tab for the list BID LIST ONLY SUPPLIER PROPERTY OWNER CERTIFICATE EXPIRATION DATE CUSTOMER updated 05.11.18