Using the product list, please use numbers to designate the items you
wish to bid on and indicate in the spaces below:

Item 1:	Item 2:	Item 3:
Item 4:	Item 5:	Item 6:
Item 7:	Item 8:	Item 9:

If you do not find the category for the item you wish to bid, on the product list, please describe:

REFERENCES (Schools Preferably)

Name of School, Location	Items Sold	Dates
1st	1st	1st
2nd	2nd	2nd

License #:
Classification #:
Comments:

Are you listed in Dunn & Bradstreet?  Yes No

Are you currently under debarment by another agency?  Yes No

Will your bid and/or a performance bond be provided upon request at no charge to the district?  Yes No

Date the application was submitted:

Please review the information carefully before submitting the form