Ohio Department of Administrative Services ▪ General Services Division
Business Office ▪ OAKS Capital Improvements / http://ci.oaks.ohio.gov
4200 Surface Road ▪ Columbus, OH 43228 / E-mail: +
Date of Request
Project Number
Legal Vendor Name
President/CEO
Federal Tax ID
OAKS FIN Vendor ID
Primary Address
City, State, Zip
County
Vendor Type / Agency / Institution / Associate (A/E) / Contractor
(select all that apply) / Construction Manager / Subcontractor / Consultant
Material Supplier / Bank
Other (describe)
Address Line Item (add additional forms for multiple vendor addresses)
OAKS FIN Address Code
Primary Address
City, State, Zip
County
Contact Name / Contact Phone
Contact E-mail / Contact Fax
Contact Fax
Short Description
(of this Address)
Organization Vendor Setup
Org. Vendor # Assigned
Local Vendor ID
Local Address Code
F010-02-CIv1211 Page 1 of 1