Form - Vendor Worksheet - Salish and Kootenai Housing Authority

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IN CASE OF MAINTENANCE EMERGENCY

Contact Tribal Law & Order at 406.675.4700 and ask for the on-call maintenance worker.

GENERAL INQUIRIES & INFORMATION

Phone 406.675.4491

Fax 406.675.4495

Email rquequesah@skha.org

Physical Mail P.O. Box 38, Pablo, MT 59855

Office 56243 US Hwy 93, Pablo, MT 59855

Hours 7a.m.–5:30 p.m., Mon–Thurs

(Except, Tribal Holidays or Tribal designated days.)

Vendor Worksheet

Vendor Worksheet
This needs to be filled out completely to get a new Vendor on the Vendor List. All information is required and if there is a section that does not apply, please enter N/A.
Vendor Name*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Remittance Address
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Contact Person*
First Last
Federal ID No.
OR Social Security #:
Alternate Phone
Mobile Phone
Fax No.
Email
Website
Net Terms*
- Immediately
- 30 Days
- Net 30
- UR
- Due on 10th
Signature*
Date*
MM slash DD slash YYYY
Notes
Please add additional information if this is pertaining to the ERAP program or any other assistance that SKHA is offering. (i.e. Tenants Name or Job Site).