Vendors Vendor Registration Greensboro Housing Authority

Vendor Registration

Please complete the vendor application/update form with the most accurate and current information. This will allow Greensboro Housing Authority Purchasing Department to enter the correct information in our vendor database.

If you are unsure which category to select when completing the Vendor Application, please refer to the list of definitions shown below.

If you have questions, please call Inell Moore at (336)303-3115 or email imoore@gha-nc.org.

Thank you for your participation in the effort.
Inell Moore, Administrative Management Specialist
Greensboro Housing Authority

**Note: City of Greensboro Privilege License is no longer required. In this field please enter n/a or 1111.

*Required Fields

Contact Information

*Company Name:

*P.O. Box/Street Address:

*City:

*State:

*Zip:

*Contact Name:

*Business Phone:

Cellular Phone:

Fax Number:

*Email Address:

*Federal Tax ID No. / Social Security No. (last 4 digits):

Company Website (if applicable):

*Section 3 Certified?

NC Contractor's License

*City of Greensboro Privilege License No.

Business Ownership Information

*In order to qualify for one of the categories below, the business must be a least 51% owned by a person of the selected category.

Note:Please be sure to complete every portion of this form that is applicable and attach certifications from local or state minority supplier development councils. A valid, original Certificate of Insurance is also required. Mail Certificate to: Attention: William Brown, Procurement and Financial Analyst , 450 N. Church Street, Greensboro, NC 27401. You can also fax the certificate to (336) 378-6954 or scan and email to invoice@gha-nc.org.

*Products and/or Services Provided by Your Business

*Signature:

Date:

*Required Fields

Definitions

Section 3 residents are defined as: 1) residents of public housing; or 2) individuals that reside in the metropolitan area or Non-metropolitan County in which the Section 3 covered assistance is expended and meet the definition of a low or very low-income person as defined by HUD.

Section 3 business are defined as one of the following: 1) businesses that are 51 percent or more owned by Section 3 residents; 2) businesses whose permanent, full-time employees include persons, at least 30 percent of whom are current Section 3 residents or were Section 3 residents within three years of the date of first employment with the business concern; or 3) businesses that provide evidence of a commitment to subcontract in excess of 25 percent of the dollar award of all subcontracts to be awarded to business concerns that meet the qualifications set forth in the two previous categories.

Asian-Indian – A U.S. citizen whose origins are from India, Pakistan, and Bangladesh.

Asian-Pacific – A U.S. citizen whose origins are from Japan, China, Indonesia, Malaysia, Taiwan, Korea, Vietnam, Laos, Cambodia, the Philippines, Thailand, Samoa, Guam, the U.S. Trust Territories of the Pacific or the Northern Marianas.

Black/Afro American – A U.S. citizen having origins in any of the Black racial groups of Africa.

Hispanic/Latino – A U.S. citizen of true-born Hispanic heritage, from any of the Spanish-speaking areas of the following regions: Mexico, Central America, South America and the Caribbean Basin only.

Native American Indian – A person who is an American Indian, Eskimo, Aleut or Native Hawaiian, and regarded as such by the community of which the person claims to be a part. Native Americans must be documented members of a North American tribe, band or otherwise organized group of native people who are indigenous to the continental United States and proof can be provided through a Native American Blood Degree Certificate (i.e., tribal registry letter, tribal roll register)

White Female – Caucasian female

White Male – Caucasian male

Other – Any category not listed in above definitions.