Bidnet, a Division Of

Address: P.O. Box 5600, Albany, New York
Phone #: (800) 677-1997 Fax #: (800) 721-6985
Return via email to:

Agency Information Form

This Block is for IPT Use Only

Account Executive: Janie Rossi / Agency ID# (on e-p server):
Main System Name: State of Michigan, Bid4Michigan / Main System ID Number: 1411
Juris ID#: / Juris Status:
Date Blocked for Msgs – BA: / Juris: Message: Blocked:

General Agency Information

Please Enter Information Here

Agency name (required)
Department name (required)
Address (required)
Address
City, State, Zip (required)
Time Zone / Eastern Central Mountain Pacific
What is the $ threshold for quotes vs. formal bids? (required)
What date will vendors be notified? / NA
What date will agency go live? (training date) / TBD
Main Contact
Title
Phone
Fax
E-mail Address

The information contained in this document is proprietary and confidential. Any copying or distribution is prohibited without the prior written consent of IPT by BidNet®. Copyright © International Data Base Corp. 2009- All rights reserved.

Agency Information Form

Please provide the contact name within your department with regards to Protests.

Main Contact for Protests
Title
Phone
Fax
E-mail Address

Agency Information Form – Department List

Please provide a list of all departments that your organization purchases for below. A link to this information will be displayed on the “vendor registration options” page. Please be as thorough as possible. Examples: Police Department, Controllers Office, Public Works Department, etc.

User #1 Information /

Please Enter Information Here

User #1 name (include salutation)
User #1 title
User #1 phone # (include area code and extension)
User #1 fax # (include area code)
User #1 e-mail address
User #1 username (4 to 10 characters)
User #1 password (4 to 10 characters)
Security Level
User #2 Information / Please Enter Information Here
User #2 name (include salutation)
User #2 title
User #2 phone # (include area code and extension)
User #2 fax # (include area code)
User #2 e-mail address
User #2 username (4 to 10 characters)
User #2 password (4 to 10 characters)
Security Level
User #3 Information / Please Enter Information Here
User #3 name (include salutation)
User #3 title
User #3 phone # (include area code and extension)
User #3 fax # (include area code)
User #3 e-mail address
User #3 username (4 to 10 characters)
User #3 password (4 to 10 characters)
Security Level
User #4 Information /

Please Enter Information Here

User #4 name (include salutation)
User #4 title
User #4 phone # (include area code and extension)
User #4 fax # (include area code)
User #4 e-mail address
User #4 username (4 to 10 characters)
User #4 password (4 to 10 characters)
Security Level
User #5 Information / Please Enter Information Here
User #5 name (include salutation)
User #5 title
User #5 phone # (include area code and extension)
User #5 fax # (include area code)
User #5 e-mail address
User #5 username (4 to 10 characters)
User #5 password (4 to 10 characters)
Security Level

User #6 Information /

Please Enter Information Here

User #6 name (include salutation)
User #6 title
User #6 phone # (include area code and extension)
User #6 fax # (include area code)
User #6 e-mail address
User #6 username (4 to 10 characters)
User #6 password (4 to 10 characters)
Security Level

User #7 Information

Please Enter Information Here

User #7 name (include salutation)
User #7 title
User #7 phone # (include area code and extension)
User #7 fax # (include area code)
User #7 e-mail address
User #7 username (4 to 10 characters)
User #7 password (4 to 10 characters)
Security Level
User #8 Information /

Please Enter Information Here

User #8 name (include salutation)
User #8 title
User #8 phone # (include area code and extension)
User #8 fax # (include area code)
User #8 e-mail address
User #8 username (4 to 10 characters)
User #8 password (4 to 10 characters)
Security Level
User #9 Information /

Please Enter Information Here

User #9 name (include salutation)
User #9 title
User #9 phone # (include area code and extension)
User #9 fax # (include area code)
User #9 e-mail address
User #9 username (4 to 10 characters)
User #9 password (4 to 10 characters)
Security Level
User #10 Information /

Please Enter Information Here

User #10 name (include salutation)
User #10 title
User #10 phone # (include area code and extension)
User #10 fax # (include area code)
User #10 e-mail address
User #10 username (4 to 10 characters)
User #10 password (4 to 10 characters)
Security Level

If you have more than 10 Users, please attach and additional page to include their information…