Get Qualified Vendor Form

Completing the Qualified Vendor Form is an essential step towards establishing a potential partnership with Mid-America Asset Management, Inc. This guide provides clear instructions on how to fill out the form accurately and thoroughly to ensure a smooth application process.

Follow the steps to successfully complete the Qualified Vendor Form.

1. Click ‘Get Form’ button to access the Qualified Vendor Form and open it in your preferred editor.
2. Start by entering the legal name of your organization in the designated field. Ensure accuracy as this will represent your entity legally.
3. Select the appropriate ownership structure by checking the relevant option: Sole Proprietorship, Partnership, Corporation, Joint Venture, or Other.
4. Provide the Doing Business As (d/b/a) name if different from your legal name, followed by your office address, primary phone number, primary fax number, email address, and website address.
5. Indicate the primary business type and list the primary officers of your organization, including their names, titles, phone numbers, and email addresses.
6. Fill in your Federal Employer Identification Number (FEIN) in the required section.
7. Identify who will serve as the primary contact person for Mid-America and specify how many years your organization has been operating under its present business name.
8. List the states where your organization is licensed to perform work and confirm if your company is in good standing with the listed states.
9. Respond to inquiries about any pending judgments, claims, arbitration proceedings, or suits, including an explanation if you answer 'Yes' to any of these questions.
10. Check if your organization has ever failed to complete work awarded to it and provide details if applicable.
11. Select the categories of work that your organization is qualified to provide with its employees.
12. Describe the general geographic region that your company services in the specified section.
13. Fill out the business classification section, noting if your business is at least 51% owned by minorities, women, or disabled veterans.
14. In the business certification section, indicate if your business is certified as a Minority Business Enterprise, Woman Business Enterprise, or Disabled Veteran Business Enterprise.
15. List your insurance coverage amounts and include any fees associated with additional insured parties.
16. Attach the required documents, including a copy of the full company insurance policy and a completed W-9 form.
17. Provide three business references including the name of the company, contact name, phone/email, and job performed.
18. Complete the owner's certification by signing, dating, and printing your name and title, confirming the accuracy of the provided information.
19. Once all fields are filled, save your changes, download, print, or share the completed form as required.

Start filling out the Qualified Vendor Form online to take the first step towards partnering with Mid-America Asset Management, Inc.