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Bid/Solicitation Order Form

 

 

PLEASE PRINT OR TYPE INFORMATION                                                    Date:                                

 

SOLICITATION NUMBER/DESCRIPTION

QUANTITY

PRICE

TOTAL

 

 

 

 

 

 

 

 

 

 

 

 

GRAND

 

TOTAL:

 

Please Mail the Bid/Solicitation package (s) listed above to: 

COMPANY NAME:  _________________________________________________________________________________

ADDRESS:  ___________________________________________________________________________

                   ___________________________________________________________________________

ATTENTION:  ____________________________________ TITLE:  _____________________________

PHONE#:  _____________________________ FAX#:  _____________________________

EMAIL:  ______________________________ DUNS#:  ____________________________

Note: Please provide a street address when filling out this form, Post Office Box addresses are unacceptable.
PAYMENT:
All document fees are payable to the Triborough Bridge And Tunnel Authority by Company check, Money Order, Visa, MasterCard, or American Express. Personal checks will not be accepted. ATM cards can not be accommodated via mail. Cash is not accepted. There are no refunds given.

CREDIT CARD: (CHECK ONE)            OR          COMPANY/BANK CHECK #:  ____________________

____ VISA     ____ MASTERCARD    ____ AMERICAN EXPRESS    CVV CODE  _______________________
(3 DIGIT CODE ON BACK OF VISA/MASTERCARD OR 4 DIGIT CODE ON FRONT AMERICAN EXPRESS)

ACCOUNT #:  ___________________________________ EXPIRATION DATE: ___________________

SIGNATURE:  ________________________________________________________________________

OVERNIGHT COURIER _____________________________ ACCOUNT # ________________________

(Documents will be mailed US Postal service regular mail if overnight courier information is not provided).

 


MAIL OR FAX THIS FORM TO:

MTA BRIDGES AND TUNNELS
2 Broadway – 23rd Floor
NEW YORK, NY 10004
ATTENTION: Procurement Administration
FAX: 646-252-7077
PHONE: 646-252-7092/7147
(E-Mail Questions: VProcure@MTABT.org )



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