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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