City of Dania Beach

VENDOR APPLICATION

A City vendor is a business, person, firm, corporation or other business entity that has completed a vendor application and is registered with the City of Dania Beach to possibly fulfill the City’s demand for products and services. The business must be fully licensed as required by the State of Florida. To become a City Vendor all of the following are required:

• Apply as a Vendor with the City of Dania Beach
• Submit a current business tax license if business is located in the City of Dania Beach
• Submit a current W-9 with application

The City’s Vendor List is updated periodically and the application is good for one calendar year at no cost to the registrant. An updated W-9 is required every year by January 31st and must be submitted to the City of Dania Beach Finance Department. Please direct any vendor questions to ap@daniabeachfl.gov or 954-924-6800 x3401.

All the * fields are required

STATE OF FLORIDA BUSINESS REGISTRATION

All vendors doing business with the City should be registered with the State of Florida. If the company is an out of state company, it should have a foreign registration with the State of Florida to do business in Florida. Companies can register online at www.sunbiz.org for a nominal fee.

IRS CERTIFICATION
Under Penalties of perjury, I certify that:

1. The number shown of this form is my correct taxpayer identification number(or I am waiting for one to be issued to me), and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and
3. I am a U.S. person (including a U.S. resident alien).

Certification Instructions

Select "Yes" if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item two (2) does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN.

PLEASE NOTE: THE STATE OF FLORIDA HAS A BROAD PUBLIC RECORDS LAW. ALL RECORDS OF THE STATE OR POLITICAL SUBDIVISIONS OF THE STATE ARE OPEN FOR PUBLIC INSPECTION AND COPYING, SUBJECT TO CERTAIN STATUTORY EXEMPTIONS. IF YOU CHOOSE TO PROVIDE PERSONAL INFORMATION SUCH AS YOUR NAME, EMAIL ADDRESS, PHONE NUMBER(S), ADDRESS OR ANY OTHER PERSONAL INFORMATION IN THIS CONTACT FORM OR OTHER FORM ON THIS SITE, UNLESS EXEMPTED BY FLORIDA STATUTES, THIS INFORMATION IS A PUBLIC RECORD UNDER FLORIDA’S GOVERNMENT IN THE SUNSHINE LAWS AND IS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. IF YOU DO NOT WANT THIS INFORMATION RELEASED IN RESPONSE TO A PUBLIC RECORDS REQUEST, PLEASE DO NOT SUBMIT THIS INFORMATION.