1

Name of Business:

Name of Business:

2

Contact Name:

 *

Contact Name:

3

Email:

Email:

4

Phone Number:

Phone Number:ext.

5

Website:

Website:

6

Federal employee identification (FEIN)#

 *

Federal employee identification (FEIN)#

7

Doing Business As (DBA)

Doing Business As (DBA)

8

Type of Business Certification (check all that apply):
51% of the business must be owned and controlled by the ethnic group claimed:

 *

Type of Business Certification (check all that apply): 51% of the business must be owned and controlled by the ethnic group claimed:

Disabled Veteran Owned Business (DVOB)

Veteran Owned Business Enterprise (VOB)

Minority Owned Business Enterprise (MBE)

Small Business Enterprise (SBE)

Women Owned Business Enterprise (WBE)

LGBTQ + Owned Business Enterprise (LBE)

Disadvataged Owned

Disability Owned

Other (Please specify)

Prefer not to say

9

Ownership type

Ownership type

African American

Hispanic

American Indian

Caucasian

Female

Asian American

Indian

Other (Please specify)

Prefer not to say

10

 Please visit our notification page to sign up for upcoming Bids/RFPs.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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