FSA-2155
Date
of
Modification:
(proposal 1)
VENDOR APPRAISER INFORMATION
Purpose: Form is used to request information from vendor appraisers and prospective vendor appraisers. |
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Handbook Reference: 1-FLP |
Number of Copies: Original. Additional copies, as necessary. |
Signatures Required: Original by vendor appraiser or prospective vendor appraiser. |
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Distribution of Copies: Original in operational filing. |
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Automation-Related Transactions: Update appraisal vendor list and update vendor profile in NATS. |
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Processing: APOC or designee will update the appraisal vendor list and create/update vendor profile information in the National Appraisal Tracking Systems (NATS). All items in Parts A-D are completed by the vendor appraiser or prospective vendor appraiser.
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Item No./ Field Name |
Instruction |
1 Return completed form to: |
FSA Appraisal Point of Contact (APOC) will insert their name, mailing address, and email address prior to sending to vendor appraiser or prospective vendor appraiser. |
Part A |
Part A is for Vendor Business information and this information should be provided once for each vendor business who will be completing appraisals for FSA. |
2 Business Name
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Vendor enters their business name. The name should be shown as it is in the SAM.gov registration. |
3 Primary Contact Name |
Vendor enters the name of the primary point of contact for the business. |
4 Business Mailing Address |
Vendor enters the business mailing address. Include city, state, and zip code. |
5 Business Physical Address |
Vendor enters business physical address (If different from mailing address). Include city, state, and zip code. |
6 Business Phone Number |
Vendor enters their business phone number. |
7 Business Email Address |
Vendor enters their business email address. |
8 Registered in SAM.gov |
Vendor indicates by check box whether the business is registered in SAM.gov (System of Award Management) or if the business is in the process of registering in SAM. If registered, vendor enters the SAM registration expiration date and completes Item 9. If not, these two items are left blank. Note: Vendor business registration in SAM.gov is a requirement for receiving an appraisal assignment. |
9 DUNS Number or UEI Number |
Vendor enters the business DUNS Number or UEI Number. The Data Universal Numbering System, abbreviated as DUNS or D-U-N-S, is a proprietary system developed and regulated by Dun & Bradstreet (D&B) that assigns a unique numeric identifier, referred to as a "DUNS number" to a single business entity. The DUNS number has been the unique identifier for registrations in SAM in the past. The Unique Entity Identifier, or UEI is the new non-proprietary identifier that will replace the DUNS number for SAM registration. The UEI will be requested in and assigned by the System for Award Management (www.SAM.gov). The UEI will replace the DUNS number by April of 2022. The vendor may enter both on the form, if they have both, but eventually, only the UEI number will be needed. |
10 State Contact Name |
State contact name is optional. If this item is blank, the primary contact above is the default contact. This field is used when a vendor business has multiple contacts. Some vendor businesses operate in multiple states with a separate contact for each state. If this is the case, then the vendor may list a separate contact and contact information for a particular state. When a state contact is entered for a state, this contact information will become the default for assignments in that state. An attachment can be used for multiple state contact entries. |
11 State |
When a State Contact Name is entered, vendor must enter a state for that state contact name. |
12 State Contact Phone Number |
When a State Contact Name is entered, vendor must enter a state contact phone number. |
13 State Contact Email Address |
When a State Contact Name is entered, vendor must enter a state contact email address. |
Parts B, C, & D |
Parts B, C, & D are for Appraiser information and this information should be provided for each appraiser within the business who will be completing appraisals for FSA. Use multiple forms if needed or submit an attachment with each appraiser’s information and signatures. |
14 Appraiser First Name |
Vendor appraiser enters first name. |
15 Appraiser Last Name |
Vendor appraiser enters last name. |
16 Resume Attached |
Vendor appraiser should attach a resume to this form and indicate by a checkbox whether a resume is attached. |
17 Physical Address (If different from business) |
Vendor appraiser enters physical address (If different from business address). Include city, state, and zip code. |
18 Phone Number (If different from business) |
Vendor appraiser enters phone number (If different from business phone). Include area code. |
19 Cell Phone Number |
Vendor appraiser enters their cell number, if applicable. Include area code. |
20 Email Address (If different from business) |
Vendor appraiser enters email address (If different from business email). |
21 License Type |
Vendor appraiser indicates the license type associated with their license, if applicable, by clicking the appropriate check box. If other is checked, please described the type of license. Vendor appraiser should attach a copy of each license to this form and indicate by clicking the checkbox to indicate whether a copy of the license(s) is (are) attached. |
22 License Number(s) & State(s) |
Vendor appraiser enters the license number and state for each state in which they hold a license and wish to receive appraisal assignments. |
23 See attached for additional comments. |
If additional comments are provided, vendor appraiser will check the box “See attached for additional comments”. |
24 Appraisal Type |
Vendor appraiser will check the box for which type of appraisals they are interested in providing - real estate appraisals, chattel appraisals, or both. |
25 Technical Reviews |
Vendor appraiser will check the box for YES or NO to indicate whether they are willing to complete technical reviews for FSA. |
26 Expert Witness/ Testimony (Optional) |
Vendor appraiser will enter their hourly rate for expert witness preparation time and their hourly rate for expert testimony time. This section is optional. |
27 Types of Properties Appraised / Specialty Properties |
Vendor appraiser will check the boxes for all types of properties in which they are competent in completing appraisal work including any specialty type property. If other is checked, please describe the type(s) of property in comments. Check all that apply. |
28 Designations |
Vendor appraiser will check the boxes to indicate which appraisal designations they have obtained as applicable. If other is checked please describe the type of designation. Check all that apply. |
29 States/Counties Appraisal Services are Provided |
Vendor appraiser indicates the state or states along with a list of the counties in each state in which they wish to be considered for appraisal assignments. The vendor appraiser may check “All Counties in the following state(s)” and include the state or states. Or the vendor appraiser may check “Designated Counties” and list the state(s) and counties in the state(s). An attached list may be included listing specific states/counties. Vendor appraiser will check the box indicating if an attachment is included. |
30 Appraiser’s Signature |
Vendor appraiser will sign the form. Appraiser’s signature is required for each appraiser within the business who will be completing appraisals for FSA. Use an attachment or multiple forms to submit information and signatures for each appraiser. |
31 Name of Appraiser |
Vendor appraiser will enter their name. |
32 Date Signed |
Vendor appraiser will list the signature date. Date format is MM/DD/YYYY. |
33 Additional Comments |
Vendor appraiser can offer any comments not covered in the information form or can clarify any responses given. |
Page
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Used by |
Author | USDA-MDIOL00000DG8C |
File Modified | 0000-00-00 |
File Created | 2022-05-11 |