COMPANY INFORMATION



COMPANY INFORMATION

Company Name      

Doing Business As      

Contact Name      

Title      

Phone Number     -     -     

Fax Number     -     -     

E-Mail Address      

Physical Address      

     

City      

State/Zip      

COMPANY DATA

Company Web Site Address      

Dun & Bradstreet Number      

Federal Tax ID #      

Legal Structure Corporation

Partnership

Sole Proprietorship

Geographic Service Capability Local

(check all that apply) Regional

National

International

COMPANY OWNERSHIP

Gender Male

Female

If Women Owned, are you a certified WBE?

Yes

No

If Yes, who is the certifying agency?      

Ethnicity African American

Hispanic American

Asian Pacific American

Native American

Asian Indian American

Are you a certified MBE?

Yes

No

If Yes, who is the certifying agency?      

Veteran Business Enterprise

Disadvantaged Business Enterprise

Small, Disabled Business Enterprise

Historically Underutilized Business Zone (HUBZone)

PRODUCTS AND SERVICES

Business Type Manufacturer

Distributor

Service Provider

Other

If Other, please describe:      

Identify the goods and/or services you provide:

Building/Facility Services

Capital Equipment

Computer Hardware, Software, and Services

Consulting Services (all categories)

Design, Engineering, and Construction Services

Financial Services

Fleet Vehicles & Fleet Management Services

Food Ingredients

In-store Merchandising Displays

Landscaping Services

Maintenance, Repairs, & Operating Supplies (MRO)

Office Supplies, Paper, Ink/Toner & Office Equipment (including imaging/copying & furniture)

Packaging Materials - direct & indirect

Pallets, Slipsheets, Airbags

Premiums & Promotional Items

Sales & Marketing Services

Specialty Printing Papers

Telecommunications Services

Temporary Staffing Services

Third Party Benefits

Transportation & Logistical Services, including small package freight

Travel Services

Uniforms

Waste Disposal Services

Include more information on the goods and/or services you provide here:

     

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