Online Vendor Application Form

If you would like to submit your Vendor Application online, please complete the form below.

GENERAL INFORMATION
Please enter your business name!
Please enter your contact name!
Please enter your street address!
Please enter your city!
Please enter your state!
Please enter your zip code!
Please enter your phone number with area code!
Please enter your fax number!
Please enter your email address.
BUSINESS TYPE & OWNERSHIP
Please select your type of business!
Please select your business ownership type!
Please enter % if woman owned business!
Invalid Input
SERVICES PROVIDED (Check All That Apply)
Please select the services you provide!
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SUPPLIES & EQUIPMENT (Check All That Apply)
Please select the supplies & equipment you provide!
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PLEASE ATTACH ALL APPLICABLE LICENSES
Invalid Input
Please attach your license(s):
Please upload your form!
Please upload your form!
Please attach your form!
PLEASE ATTACH ALL APPLICABLE CERTIFICATIONS
Invalid Input
(*List Jacksonville Housing Authority as Certificate Holder)
Please attach your certification(s):
Please attach your certification!
Please attach your certification!
Please attach your certification!
Enter Numbers:
Please enter the number code!

 

Jacksonville Housing Authority
1300 N Broad Street, Jacksonville, Florida 32202
Phone: (904) 630-3810

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