FORM-DPP-COMM-VM-002-2024 / Effective: 04-15-2024 Department of Property and Procurement Vendor Management PREFERRED BIDDERS APPLICATION A Preferred Bidder is a bidder afforded preferential treatment over other non-preferred bidders after attaining preferential bidder status. A preferred bidder must meet the requirements indicated in Title 31, Chapter 23, Section 236a of the Virgin Islands Code, the Preferred Bidders Statute. An applicant must meet the Licensing requirement in addition to the Residency or Ownership requirement, pursuant to the Preferred Bidders Statute. See Preferred Bidder’s Checklist. APPLICANT’s LEGAL NAME: OFFICE PHONE: CELL PHONE: EMAIL: MAILING ADDRESS: PRINCIPAL PLACE OF BUSINESS ADDRESS: OTHER BUSINESS LOCATIONS (STORES, WAREHOUSES, ETC.): Date of Last Financial Statement: Assets: Liabilities: Net Capital: Type of Entity: [ ] Sole Proprietorship [ ] Partnersh [ ] Corporation [ ] LLC, LLP [ ] Other_________ Date of Formation/Incorporation: Location of Formation/Incorporation: NAME OF PRINCIPALS TITLE OF PRINCIPALS 1. 2. COMMERCIAL AND BANK REFERENCES 1. Name 2. Mailing Address Phone Number Name 3. Mailing Address Phone Number Name Mailing Address Phone Number NAMES OF PERSONS AUTHORIZED TO ACT ON BEHALF OF APPLICANT TITLE 1. 2. NAMES OF PERSON(S) HOLDING 51% LEGAL OR EQUITABLE OWNERSHIP NAMES OF PERSON(S) MEETING RESIDENCY or BIRTH REQUIREMENT INDUSTRY: GOODS / SERVICES APPLICANT IS INTERESTED IN SUPPLYING TO THE GOVERNMENT Authorized Signature Title Date By submitting this application, Applicant certifies that all information and statements provided in the Preferred Bidders Application is true, accurate, and complete. The Applicant understands and agrees that the Department of Property and Procurement (DPP) will verify the contents of the Application. The Applicant further authorizes third parties to release information relating to this Application. If any false or incomplete information is found, the DPP reserves the right to reject this Application, and/or rescind any approval or certification granted. TERRITORY OF THE VIRGIN ISLANDS ) JUDICIAL DIVISION OF ___________________________ ) On this _______ day of _______________________before me personally appeared _________________________________ Known to me to be the person who executed the foregoing Preferred Bidders Application, a voluntary act of his/her free will, for the uses and purposes therein set forth. Given under my hand and seal. Notary Public My commission expires: Instructions: Fill in all spaces. All answers should be typed or printed.