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Attachment F <br />Submit with RFI' <br />VENDOR DATA SHEET <br />PLEASE NOTE: This address willbe used tet_.__ <br />._.__o determine local purchasing preference, if <br />applicable. Mailing address where County purchase orders/contracts are to be mailed: <br />1. COMPANY NAME: <br />ADDRESS: <br />CITY: STATE: L1I'+4 <br />TEL: TOLL FREE TEL. FAX: <br />2. Local Vendor <br />_ _ _ _.... ....... <br />Indicate if your firm/company has an established place of business located in any of the <br />following Wisconsin Counties. An established place of business means a physical office, plant <br />or other facility. A post office box address does not qualify a vendor as a Local Vendor. <br />❑Dane County j ❑Columbia County ❑ Dodge County El. Green County <br />❑ Iowa County El Jefferson County �❑ Rock County ❑ Sauk County <br />�3. ! Contact person in the event there are questions about your bid/proposal: <br />r <br />NAME TITLE: j <br />TEL j TOLL FREE TEL <br />FAX ( E-MAIL <br />RFP # 113105 <br />6 <br />