2019-2020: Vendor Application
Thank you for your interest in becoming a vendor for Pacific Charter Institute and its family of schools: Heritage Peak Charter School, Rio Valley Charter School, Valley View Charter Prep, and Sutter Peak Charter Academy. Please complete all sections of this request form for consideration to become an Active Vendor with PCI.

NOTE: Please proofread your responses/answers as they will not be automatically corrected.
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Vendor Information
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Service Information
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Additional Business Information
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Insurance Liability Questionnaire
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PCI Invoice Requirements & Active Vendor Protocols
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Agreement & Acknowledgement
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Vendor Information
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Service Information
3
Additional Business Information
4
Insurance Liability Questionnaire
5
PCI Invoice Requirements & Active Vendor Protocols
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Agreement & Acknowledgement
  • Business Information

  • The Business Name will be used as the listing on the public listing of the Active Vendor List upon application approval.
  • This will be listed on the public listing of the Active Vendor List upon application approval
  • This will be listed on the public listing of the Active Vendor List upon application approval.
  • COUNTY the business is located. This will be listed on the Active Vendor List upon application approval.
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    This will be listed on the Active Vendor List upon application approval.
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    This will be listed on the Active Vendor List upon application approval.
  • This will be listed on the Active Vendor List upon application approval.
  • This will be listed on the Active Vendor List upon application approval.
  • Owner/Manager Information

    Complete this section if different from Business Information.
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  • Payment Information

  • Click on Browse to locate and attach a copy of your W-9. In order to issue payment on future invoice submissions should this application be approved, the W-9 must be filled out in its entirety. Failure to attach a completed W-9 may result in a delay to the application process. Acceptable file formats include .jpg, .jpeg, .pdf, and .png.
  • Pay to the order of must match the information provided on the W-9.
  • Address of where checks and correspondence will be mailed. Complete if different from Business Address.
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