Vendor Registration
Vendor Registration Application
TriWest has established a Vendor Registration Application process which is administered to encourage fair competition and provide interested
and qualified vendors with an opportunity to offer their products and/or services. The Registration Application is used to identify
applicable vendors for specific procurements, especially formal Requests for Proposal. This system also provides TriWest with more information
about current and potential new vendors, facilitates communication, and better identifies procurement sources.
In order to register with TriWest, you must submit
both a Vendor Registration Application and an I.R.S. W-9 Form. Your
application will not be accepted unless both forms are submitted to the Purchasing Department at the address listed on the Vendor Registration
Application. The forms may be faxed to TriWest if you prefer.
Note: The forms are presented here as fillable forms which can be filled in online and then printed. They will not be saved to the website. Alternatively, you may print the form and complete the hard copy version.
Vendor Registration Application
I.R.S. W-9 Form
Definition of Small Business Categories for Vendor Registration Application
Small Business:
Located in U.S., organized for profit, including affiliates, is independently owned and operated, not dominant in field of operations
in which it is bidding on government contracts, and meets Small Business Administration size standards included in the solicitation.
The size standard is based upon the North American Industrial Classification (NAICS) assigned to the specific procurement dependent
upon product/service purchased. Self-certify.
Small Disadvantaged Business:
Small Business, unconditionally owned and controlled by one or more socially and economically disadvantaged individual who is of good
character and a citizen of the U.S., and SBA-certified.
Woman Owned Small Business:
Small Business, at least 51% owned by one or more woman, and management and daily business operations controlled by one or more woman.
Small Business 8(a) Certified (8a):
Small business, SBA-certified as a SDB, and SBA-certified into the 8(a) Business Development Program for a period of 9 years.
Historically Underutilized Business Zone (HUBZone):
Small Business, owned and controlled 51% or more by one or more U. S. citizen, and SBA-certified as a HUBZone concern (principal office
located in an economically distressed HUBZone area and 35% of employees live in any designated HUBZone).
Veteran Owned Small Business (VOSB):
Small Business, veteran-owned as defined in 38 USC 101 (2); greater than 51% owned by one or more veteran and management and daily operations
controlled by one or more veteran.
Service-Disabled Veteran Owned Small business:
Small Business, veteran-owned, greater than 51% owned by one or more service-disabled veteran, and management and daily business operations
controlled by one or more service-disabled veteran or in the case of veteran with permanent and severe disability, the spouse or permanent
caregiver of such veteran, and with 0%-100% service-connected disability as defined in 38 USC (101)(16) and document on DD214. Self-certify.
Small Business Representations and Certifications
TriWest Healthcare Alliance is a federal government contractor. You, as a TriWest vendor, must annually provide certain representations
and certifications with respect to your company so that TriWest can report to the federal government regarding satisfaction of its small
business contracting and retention goals and to ensure that federal funds are spent in accordance with federal law. Failure to provide
the requested information may mean that TriWest can no longer utilize your services.
TriWest mails the form below to all its registered small businesses on an annual basis and also makes the form available via this Web
site. When you receive the form, please complete it and mail or fax it to TriWest Healthcare Alliance at the contact information provided
on the Purchasing Contacts page.
Representations and Certifications
