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SUPPLIER INFORMATION APPLICATION

form steps

As a supplier/contractor for the Omaha Public Power District, we require the following documents to be in our possession before a contract/purchase order can be issued or work can commence: Supplier Information, signed W8 (foreign vendors) or signed W9, and completed W-4NA (if applicable), and a Certificate of Liability Insurance.

You must select either the W-9 or W-8 button to complete the form.
Link to W-9 form.
Link to W-8 form.
What's this? Link to W-4NA form.
Link to W-4NB form.
Submit documents via fax to 402-636-3931 or Upload Files On the Summary page using the link below or email to SCM@oppd.com.

CONTACT INFORMATION

(The person OPPD may contact about this supplier information)
FIRST NAME
LAST NAME
PHONE
FAX (if applicable)
E-MAIL ADDRESS
CONFIRM E-MAIL
PREFERRED RESPONSE METHOD (SELECT ONE)
WOULD YOU LIKE TO ADD AN ADDITIONAL CONTACT TO THE ACCOUNT?

BUSINESS INFORMATION AND MAILING ADDRESS

BUSINESS NAME
DOING BUSINESS AS
DUNS (DUNN & BRADSTREET NUMBER) XX-XXX-XXXX  -  -  What's this?
ADDRESS LINE 1
ADDRESS LINE 2
ADDRESS LINE 3
CITY
STATE/ PROVINCE/ REGION
COUNTRY
ZIP/POSTAL CODE
WEB SITE ADDRESS (URL)
WHAT COMMODITIES/ SERVICES DO YOU SUPPLY?

REMIT ADDRESS

(Company Name & Remit-To Address, if different from above.)

ADDRESS LINE 1
ADDRESS LINE 2
ADDRESS LINE 3
CITY
STATE/ PROVINCE/ REGION
COUNTRY
ZIP/POSTAL CODE

OWNERSHIP

   

CONTROLLING INTEREST

(Please Indicate controlling interest if owned by both a male and female.)
% MALE    % FEMALE 

RACIAL CATEGORY

(Please check as many as apply.)
       

OPPD CONTACT

Is an OPPD employee currently assisting you in becoming a Supplier? Please provide name(s)