VSM New Vendor Application

  Company Information
  *Company Name :  
  CAGE :  
  *Street Address 1 :  
  Street Address 2 :  
  *City :  
  *State :    
  *Zip :  
  Point of Contact Information
  *First Name:    MI :    *Last Name:
  *Phone Nbr :      
  *E-mail Address :    
  Fax Nbr :  
  *Contract Type
  *Inventory Control Points w/Current Contracts
  If you checked "EDI", please provide the following info :
  (This information will allow your Purchase Order Information to be available in VSM on the same day the award is made.)
  Routing Number Group Segment (GS) :  
  Interchange Segment (ISA) :  
  * Asterisk denotes required fields