General Supplier Info Form

Dear College Supplier:

Albert Einstein College of Medicine, Inc. utilizes Banner Finance as our ERP System. We must maintain our vendor database to ensure the information we have about your company is accurate. We are asking that you provide specific key pieces of information which include, but are not limited to the following: Company Name; Address; Remit to Address; Telephone; Fax; Primary Contact Name; Email Address; etc.

In addition, we need certification as to your SBA business classification (large, small, woman owned, disadvantaged, etc.) and a current W-9 or W-8 form must also be on file. Finally, you will be required to affirm our conflict of interest statement, as well as our terms and conditions. All of the above required information can be entered via our online “General Supplier Information Form”. To access this form (Qualtrics, Inc.), please click on the link below:

To continue to process your purchase orders and pay your invoices in a timely manner, we need to have this information entered into the new system as soon as possible. Therefore we strongly request that you complete this form to continue doing business with Albert Einstein College of Medicine, Inc.

As a reminder: All purchases of goods and services for Albert Einstein College of Medicine, Inc. must be from approved vendors who will only accept a purchase order, and will not provide these goods or services without one. Your company should NOT, therefore, accept orders nor perform services without and authorized purchase order.

We would like to thank you in advance for your cooperation and look forward to a successful implementation of our new Financial System.