• Grainger Affiliation Form

Grainger Affiliation Form

Contract #102109-WWG for Facilities, Maintenance, Repair and Operating Related Supplies, contract #091311-WWG for Science Curriculum and/or Educational Research Related Supplies, Equipment & Accessories, contract #123011-WWG for Public Safety Related Equipment with Supplies, Accesorries and Services, contract # 110811-WWG for Professional Consulting Services with Related Supplies and Accesorries between The National Joint Powers Alliance (NJPA) and Grainger, is made available to all NJPA Participating Members. All NJPA Members will need to complete this Grainger Contract Participation Form to become affiliated to this agreement, and to ensure that they receive all of the benefits of the Vendor Agreements #102109- WWG, #091311-WWG, #123011-WWG, and #110811-WWG.

A paper version of this affiliation document is also available and may be faxed to the attention of the "Grainger Contract Coordinator" at 610-523-5592.

Please review and complete the required information below and return to Grainger for enrollment into the agreement.

The NJPA Member Understands & Acknowledges:

  • May elect to participate in only one (1) Grainger catalog-wide agreement at any given time.
  • Agrees to purchase MRO equipment and supplies in accordance with Vendor Agreement #102109-WWG and #091311-WWG, (the Vendor Agreement) resulting from IFB #102109 and RFP #091311.
  • This Contract Participation Form and the above referenced Vendor Agreement supersedes all previous declarations for the purchase of product from Grainger.
  • The NJPA Member further understands that enrollment will remain in effect during the contract term including any contract extensions.
  • For agreement, the initial contract term will expire on January 31, 2014, with an opportunity to for NJPA and Grainger to agree to one additional renewal year, through January 31, 2015. 
  • For agreement #102109-WWG, the contract term will expire on January 31, 2014.
    For agreement #091311-WWG, the contract term will expire on November 1, 2015.
    For agreement #110811-WWG, the contract term will expire on January 31, 2016.
    For agreement #123011-WWG, the contract term will expire on January 31, 2016.  
  • NJPA Members who affiliate to Vendor Agreement #102109-WWG/091311-WWG after October 31, will be eligible to receive all the contract benefits with the exception of the NJPA Member Incentive. The NJPA Member Incentive will commence on February 1 of the next contract year.

 

* NJPA Member ID:
Contact NJPA if you do not have your Member ID.
 
* NJPA Member Name:
* Address:
* City:
* State:
* Zip:
* Please list your NJPA Member existing Grainger Account(s) (separate with commas):
 
The above named NJPA Member is requesting that all NJPA Member accounts be enrolled under the Vendor Agreement #102109-WWG for the purposes of purchasing maintenance, repair, and operations supplies and equipment from Grainger. Please allow 5-10 business days for processing.
 
Accepted and agreed; On Behalf of the Participating Member Above:
 
* Name:
* Title:
* Email:
By clicking "submit," you are indicating you are authorized to approve the described affiliation, and are approving this form's entries in lieu of a physical signature.
 
* Required Fields