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Attachment B <br />Submit With RFP <br />VENDOR REGISTRATION CERTIFICATION <br />Per Dane County Ordinance, Section 62.15, "Any person desiring to bid on any county <br />contract must register with the purchasing manager and pay an annual registration fee of <br />$20." <br />Your completed Vendor Registration Form and Registration Fee must be received for your bid <br />to be considered for an award. Your bid/proposal may not be evaluated for failure to comply <br />with this provision. <br />Complete a registration form online by visiting our web site at www.danepurchasing.com.. You <br />will prompted to create a username and a password and you will receive a confirmation <br />message, than log back in and complete the registration. Once your registration is complete <br />you will receive a second confirmation. Retain your user name and password for ease of <br />re -registration in future years. <br />Payment may be made via credit card on-line or by check in the mail or in person at the <br />Purchasing Division office. If paying by check make check payable to Dane County Treasurer <br />and indicate your federal identification number (FIN) on the subject line. <br />CERTIFICATION <br />The undersigned, for and on behalf of the PROPOSER, BIDDER OR APPLICANT named <br />herein, certifies as follows: <br />❑ This firm is a paid, registered vendor with Dane County in accordance with the bid terms <br />and conditions. <br />Vendor Number # Paid until <br />Date Signed: <br />RFP # 113105 <br />2 <br />Officer or Authorized Agent <br />Business Name <br />