Vendor Checklist (New Application)

The following must be returned to the Poarch Band of Creek Indians Tribal Gaming Commission:

A. Submissions Applicable to the Business Entity

• Vendor Application
• Company/Principal/Employee Vendor Terms and Conditions Form (Print, Initial and Sign)
• Company/Principal/Employee Vendor Release of Information Form (Print, Sign and Notarize)
• Disclosure, Authorization, and Consent For Release of Background Information (Print, Complete and Sign)
• Required Cover Sheet
• Preceding year tax return for all non-publicly traded companies
• Most recent 10-K filing for all publicly traded companies
• Preceding year's profit and loss statements
• An organizational chart of the business down to the department head level
• A complete list of all stockholders or members showing the number of shares of record held by each for non-publicly traded companies and a complete list of all officers and directors for publicly traded companies
• Business formation documentation (i.e. Articles of Incorporation, Articles of Organization, and Partnership Agreements)
• $5,000 application fee for a Gaming Vendor or $500 application fee for a Non-Gaming Vendor who does a minimum of $50,000 of business annually
• Vendors who do less than $50,000 of business annually may be exempt from completing a Vendor Application, but principals and employees must complete required application
• Gaming Vendors are required to pay $5 per machine per month. Example: 10 Games = $50 per month

B. Submissions Applicable to the Principals

• Principal Application for each officer, director, partner, and/or owner of ten percent (10%) or more of the Gaming Vendors and Non-Gaming Vendors. (If a Non-Gaming Vendor is a publicly traded business, the Non-Gaming Vendor does not submit a Principal Application, but the most current 10-K filing and a list of officers and directors for the vendor.)
• Company/Principal/Employee Vendor Terms and Conditions Form (Print, Initial and Sign)
• Company/Principal/Employee Vendor Release of Information Form (Print, Sign and Notarize)
• Disclosure, Authorization, and Consent For Release of Background Information (Print, Complete and Sign)
• Required Cover Sheet
• Two identification photos (see Vendor Application Instructions)
• A copy of Drivers License and Social Security Card
• $500 application fee for each officer, director, partner, and/or owner of ten percent (10%) or more of a Gaming Vendor who is required to make application in Section A above or $100 application fee for each officer, director, partner, and/or owner of ten percent (10%) or more of a Non-Gaming Vendor who is required to make application in Section A above.
• $100 application fee for each officer, director, partner, and/or owner of ten percent (10%) or more of a Vendor not required to make application in Section A above

C. Submissions Applicable to the Employee

• Employee Vendor Application for any employee who anticipates being physically on-site more than six times a year at any of PCI Gaming Authority's gaming enterprise locations
• Company/Principal/Employee Vendor Terms and Conditions Form (Print, Initial and Sign)
• Company/Principal/Employee Vendor Release of Information Form (Print, Sign and Notarize)
• Disclosure, Authorization, and Consent For Release of Background Information (Print, Complete and Sign)
• Required Cover Sheet
• Two identification photos (see Vendor Application Instructions)
• A copy of Drivers License & Social Security Card
• Current DMV printout (if requested)
• $300 application fee for each Gaming Vendor employee whose company is required to make application in Section A above or $100 application fee for each Non-Gaming Vendor employee who's company is required to make application in Section A above
• $100 application fee for all other vendor employees whose company is not required to make application in Section A above