City of Marietta Purchasing Vendor Additional Information

Purchase Order Information

Purchase Order Vendor Name *
Address
City
State
Zip
Contact Name
Phone #
Email Address

Remittance Information

Remittance Name
Address
City
State
Zip
Contact Name
Phone #
Email Address
Tax ID
Name on Checks

EFT Information

ACH Routing Number *
Bank Name *
Account Number *
W-9 (required) *