City of Largo, Florida

On-Line Vendor Application

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On-Line Vendor Application

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Please fill out the Vendor Application as complete as possible.

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Date

Name of Company	*
Address	*
City	*
State	*
ZIP Code	*	- Second portion of ZIP Code is optional.
Remittance Address
Remit City
Remit State
Remit ZIP Code		- Second portion of ZIP Code is optional.
Phone Num		-- ext
Fax Num		-- ext
Email Address

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