GSAfleet.gov Vendor Company Request Form

GSAfleet.gov Vendor Company Request Form
Solicitation Number:

Program:

Please complete the following fields required to create an GSAfleet.gov account for this announcement. Required fields are marked with an asterisk (*).
Vendor name*
Unique Entity Identifier (UEI)*
Physical street address*
Physical street address line 2
City*
State*
Country*
Payment street address*
Payment street address line 2*
City*
State*
Country*
Vendor phone (including country code)*
Vendor fax (including country code)
Vendor website
Vendor point of contact*
Vendor point of contact email
Vendor point of contact phone (including
country code)
Type of supplier (choose one)*
Vendor store type (choose one)*

Vendor makes (add as many as needed) i.e.
Ford, Nissan, Jeep, Chevrolet*
Certificate of origin notifications (add up to five
email addresses)*
Order transmission email addresses (add up to
five email addresses)
Vendor administrator name (first and last)*
Vendor administrator email*
Vendor administrator phone (including country
code)*

Dealer - Reseller
Original Equipment Manufacturer
Corporate
Dealership
Franchise
Independent