* Direct Deposit Information, if applicable
(Obtain a copy of the vendor's voided check or a copy of the bank statement showing the vendor's name and bank account routing number from the vendor's financial institution. Scan the voided check or bank statement and attach the copy to the E-Form. If a scanner is not available, fax to ATTN: Vendor Specialist at 501-324-9311).
* Telephone number
* Fax number
* E-mail address (if desired by the vendor that such be entered)
* Minority Indicator information, and
* 1099 Reportable status
* Checking the AASIS master vendor system to verify that there is no file already in existence in AASIS for this vendor name and address;
* Verifying that the name is not on the DHS Excluded Providers list found at: https://dhsshai-e.arkansas.gov/OFA/ExclProv/default.aspx
NOTE: To be granted access to view the DHS Excluded Providers list, DHS staff person must have passed a Criminal Background
Check and must have been granted access to the list by Vendor Maintenance Specialist in Contract Support Section.
* Verifying that the name is not on the OSP Suspended/Debarred Vendors list and State and Federal Excluded Parties List, found at:
http://www.dfa.arkansas.gov/offices/procurement/guidelines/Pages/default.aspx)
http.y/www.dfa.arkansas.gov/offices/procurement/Documents/vendorMaintenance.pdf
* The name and address are not already in AASIS;
* The vendor is /TOf listed on the DHS Excluded Providers list;
* The vendor is not listed on the DFA/OSP Suspended/Debarred Vendors list;
* The vendor is not listed on the Federal Debarment Vendor List.
* The existing vendor number, tax information, and vendor's PREVIOUS address information,
* Agency contact information, and
* Any and all information that is being CHANGED.
DHS_VendorMaintenancelssues@Arkansas.qov for the person responsible for processing vendor actions.
Office of Finance and Administration Contract Support Section General Services Unit P.O. Box 1437/Slot Number W304 Little Rock, AR 72203-1437 Telephone: 683-4818
016.14.12 Ark. Code R. 004