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Vendor Intake Form
"Need a comprehensive Vendor Intake Form for a healthcare technology company that includes enhanced data security sections and HIPAA compliance requirements, to be implemented by March 2025 for all new suppliers providing software services."
1. Vendor Information: Basic company details, contact information, tax identification
2. Business Classification: Company type, size, diversity status
3. Tax Information: Tax ID, withholding requirements, state tax registration
4. Payment Information: Banking details, payment terms, preferred payment method
5. Compliance Certifications: Required licenses, permits, certifications
1. Insurance Information: Insurance coverage details, when required by contract value or service type
2. Security Questionnaire: For vendors with data access or system integration requirements
3. Export Control: For international vendors or those dealing with controlled items
4. Sustainability: Environmental compliance and sustainability practices, if relevant to procurement policies
1. W-9/W-8 Forms: Tax documentation forms
2. Insurance Certificates: Proof of required insurance coverage
3. Licensing Documentation: Copies of relevant business licenses and permits
4. Bank Verification Letter: Confirmation of banking details for payment setup
5. Diversity Certifications: Documentation of diversity status claims
Authors
Supplier
Services
Products
Company
Business Day
Confidential Information
Effective Date
Payment Terms
Purchase Order
Tax Identification Number
W-9
W-8
Business Classification
Diversity Status
Insurance Coverage
Compliance Requirements
Banking Information
Authorized Representative
Contract Value
Service Level Agreement
Quality Standards
Delivery Terms
Force Majeure
Governing Law
Jurisdiction
Notice
Term
Termination
Data Protection Laws
Business Profile
Tax Status
Payment Terms
Insurance Requirements
Compliance Certifications
Data Privacy
Confidentiality
Information Security
Business Classification
Diversity Status
Product/Service Description
Quality Assurance
Ethics and Code of Conduct
Environmental Compliance
Health and Safety
Export Control
Anti-Corruption
Conflict of Interest
Bank Details
Contact Information
Authorized Signatories
Business References
Licensing and Permits
Geographic Coverage
Capacity and Capabilities
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