* Contact's First NameSupplier Registration FormPlease fill in all the applicable fields. Fields with an asterisk (*) are required.* Name of Applicant Business* Person filing this form:First Name* Title E-Mail* Type of Organization:* Tax ID NumberLast Name* For Proprietorship or Self Employed - Enter Business Owner's full name:Owner's First NameOwner's Last Name* Enter Owner's personal Social Security No. (if different from Tax ID above):Social Security NumberMailing Address (for bids, purchase orders, etc.):* Contact's First Name* Contact's Last Name* Title* Mailing Address* City* State*Zip/Postal CodePayment Address:* Contact's Last Name* Title* Payment Address* City* State* Zip/Postal Code* PhoneExt.FaxE-Mail* PhoneExt.FaxE-MailNames of Officers, Members of Partnership, Owners, etc.:* NameNameNameName* TitleTitleTitleTitle NIGP Commodity Class CodesPlease select commodity class codes which describe the goods/services you provide.The commodity codes are available through the NIGP 5 Digit Numerical Commodity Code (A commodity code must be selected and*listing button.entered onto the form.)*(Copy and paste codes in area below.)Cannot find your NIGP 5 Digit Numerical Commodity Code? See instructions below.**If you cannot find your NIGP 5 Digit Numerical Commodity Code from the commoditycode listing, enter a description in the comments box below to identify your productsand/or services. Type License #NOTICE TO CONTRACTORS: Invitations to bid on construction projects are disseminated Business Group:Choose any of the following if applicable:Select one of the following ethnicity's:Choose one of the following classifications, if applicable:CERTIFICATION:NOTICE: There is no requirement by Clark County to be certified. The collection of activated in our database.* Standard terms offered:NOTICE TO USERS: By clicking " Submit Application," I certify that the information stated above is factual and true, and that my taxpayers identification or my social security number is correct.* Country* CountryProvinceProvinceNIGP Commodity Codes Listingonly through the following methods: Bid Schedule available through the Fax On Demand - (702) 455-5428; advertisement in the Legal Notices section of the local newspapers; local business chamber associations; and trade publications.ethnicity and gender data is for statistical and demographic purposes only.Certificates may be faxed to our office at (702) 386-4914 or mailed to our officeat the address provided below.NOTE: Vendors are required to provide proof of certification renewal accordingly.Failure to submit proof of certification renewal within 90 days of expirationwill result in the deactivation of the vendor certification listing.Clark County Finance - Purchasing and Contracts500 S Grand Central Pkwy4th FloorLas Vegas, NV 89106702-455-2897Contractor's Information:TypeTypeLicense #License #$ Limit$ Limit$ LimitBusiness Enterprise Type: