Philadelphia Parking Authority's Vendor Registration Form

Thank you for interest in doing business with the Authority. Please complete the form below to register with the Authority's Procurement Department.

Please describe the goods/services you provide.*

Contact*

Title*

Company Name*

Office Phone Number*

Mobile Number*

Email Address*

Company Address*

City*

State*

Zip Code*

Is your remittance address different from the address above?*

Yes

No

Remittance Address*

Is your company a Small or Small Diverse Business Enterprise certified by the Pennsylvania Department of General Services?*

For more information or to self-certify please visit https://www.dgs.pa.gov/Small%20Diverse%20Business%20Program/Small-Diverse-Business-Verification/Pages/default.aspx

Yes

No

Designation*

SMALL

DSBE

LGBTBE

MBE

MWBE

VBE

WBE

OTHER

Other Designation*

Please upload your Small Business Procurement Initiative Certificate.

Drag and drop files here or

Do you participate in any cooperative contracts or have any government contracts?*

Select

If yes, please provide the contract number and the entity with whom you are contracted with..*

If available, please provide your Philadelphia Business Activity License Number.

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