Rock Island County, IL · Rock Island County
Company Contact Request
Businesses use this form to provide Rock Island County with vendor contacts and business ownership classification information.
At a glance
- Issued by
- City of Rock Island County · Rock Island County, Rock Island County, Illinois
- Notarization
- Not required: file this form without a notary.
- Official source
- rockislandcountyil.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The Company Contact Request lets a business identify itself as a new or existing vendor and provide contact details and ownership classifications. The form asks for vendor and contact names, phone numbers, email addresses, applicable diversity or business classifications, and a signature and date. It also asks how ownership information is certified and requests a completed W-9 and applicable ownership certificates.
Who needs it
Businesses providing vendor contact and ownership information to Rock Island County should complete this form and include the requested W-9 and applicable certificates.
How to submit it
Sign and date the form, then send it with a completed W-9 and applicable ownership certificates to Rock Island County, 1504 3rd Avenue, Rock Island, IL 61201.
About notarization
This document is signed without a notary; the signer certifies the information under penalties of perjury and signs and dates the form.
How to submit this form
- 1
Download the Form
Download the Company Contact Request PDF.
- 2
Complete the Form
Provide vendor and contact details, select applicable ownership classifications, and indicate how you are certifying.
- 3
Gather Attachments
Include a completed W-9 and applicable certificates of ownership.
- 4
Sign and Submit
Sign and date the form, then send it with the attachments to Rock Island County at 1504 3rd Avenue, Rock Island, IL 61201.
Frequently asked questions
- What is the Company Contact Request for?
- Businesses use it to provide vendor contact details and identify applicable ownership classifications for Rock Island County.
- What should I include with the form?
- Return the form with a completed W-9 and applicable certificates of ownership. The form also asks you to indicate whether you are attaching certificates or self-certifying.
- Do I need a notary for the Company Contact Request?
- No. The document is signed without a notary; the signer certifies the information under penalties of perjury and signs and dates the form.
- How do I submit the Company Contact Request?
- Send the signed and dated form with a completed W-9 and applicable ownership certificates to Rock Island County, 1504 3rd Avenue, Rock Island, IL 61201.