Central New Mexico Community College
VENDOR REGISTRATION FORM

Purchasing Department
CNM
525 Buena Vista SE
Albuquerque, NM  87106

 Office Use Only:
Supplier #__________________
Date Entered________________
Operator Initials_____________

Company Name                                 

Company Contact:                              

Address                                              

City                                                    

State                                                                   Zip Code 

Remit Address (if different from above)

City                                                    

State                                                                 Zip Code   

E-Mail or Website Address                

Telephone                                            Ext.  

Fax                                                         

Federal Tax ID Number (TIN)             

NM CRS Number                                 

NM Residential Preference Number    (if applicable)

Company Affiliation (if applicable)       (if applicable)

List any statutory agents, officers, members or owners of your company who can sign legally binding documents.

1) Name                                             
    Title                                                
2) Name                                             
    Title                                                
3) Name                                             
    Title                                                

A minority business enterprise (MBE), or women business enterprise (MBE) has at least 51% minority or female ownership and its daily operations are managed/directed by one or more minority or female owners.

Type of Company:                                       MBE    WBE

Number of Employees:                         Full Time            Part Time  

Years in Business:                               

Please specify any early-payment discount you will extend to CNM.  For example, 2% 10, 1% 15, Net 30 means you allow a 2% discount if payment is remitted within 10 days and 1% discount within 15 days or full amount is to be paid within 30 days.

Payment Terms                                   

Please list any state (SPD) or federal (GSA) contract numbers your company agrees to extend to CNM.

Contract Number                               
Relevant Dates:                                    From              To

Contract Number                               
Relevant Dates:                                     From              To

Contract Number                               
Relevant Dates:                                     From              To

Below is a list of Commodity Codes for which you can register as a potential supplier.  Please scroll through the listing and enter them below.

1.    
2. 
3. 
4. 
5.