WSCA — Grainger Political Subdivision Contract Participation Form - Grainger WSCA Price Agreement #1862

Price Agreement #1862, in conjunction with each states Participating Addendum, a multi-state catalog-wide Contract, for Facilities Maintenance, Lighting Products, Industrial Supplies and Tools between the Western States Contracting Alliance (WSCA), and Grainger ("Grainger's WSCA Agreement #1862"), is made available to all Political Subdivisions (Local Government, Higher Education, Primary Education, as authorized in the state) within a Participating State, herein referred to as Political Sub-Division. All Political Sub-Division need to complete this Grainger Contract Participation Form to become affiliated with and receive the benefits from Grainger's WSCA Agreement #1862, Including each state's Participating Addendum. Please review and complete the required information below and send to Grainger for participation under the Agreement by clicking the "Submit" button.

The Political Sub-Division acknowledges and understands the following for contract compliance and audit purposes:

 • They may participate in only one (1) Grainger catalog-wide agreement at any given time and by completing this form the Poli Sub is indicating its desire to purchase Maintenance, Repair, and Operating (MRO) equipment and supplies in accordance with Grainger's WSCA Agreement #1862 and the state's Participating Addendum.
 • That their participation under Grainger's WSCA Agreement #1862 shall be for a minimum of twelve consecutive months, except to the extent that the Poli Sub advises Grainger of its desire to terminate under this contract.

Asterisk (*) indicates required information.

*Organization Name
*Requestor Name
*Requestor email Address
*Requestor Phone   Ext.
*Organization Address 1
Organization Address 2
Organization City
*Organization State
*Organization ZIP
Please list your WSCA Member
existing Grainger Account(s):

Poli-Sub Information

The above named Poli-Sub is requesting that all associated accounts be enrolled under this agreement, for the purposes of purchasing maintenance, repair, and operating supplies and equipment from Grainger. By clicking the "Submit" button, I hereby certify that I am the above person, and have authority to make contracting decisions such as this for my organization.

Please allow 4-7 business days for processing.