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Vendor Qualification Form
Please enter correct, complete and accurate data in this form !
Is your company :
*
Manufacturer
Distributor
Retailer
Wholesaler
Consultant
Factory
Leasing
Service
Repair or Maintainance
Other
Company Certifications :
MBE
WBE
DBE
VOSB
SBE
JSEB
Other
Type of Ownership :
*
Sole Proprietor
Partnership
Corporation
LLC
Non-Profit
Other (specify)
Please indicate type of account:
Checking
Savings
Established line of credit :
*
Yes
No
*
I have the authority to provide such information on behalf of my company.
I understand that this information may be used to determine and report to the Government my company's status as a small, veteran-owned small, service-disabled veteran owned small, HUBZone small, small disadvantaged, or women-owned small business and that misrepresentations could result in Federal penalties.
Your Company Name
Facebook
Twitter
Linkedin
Google+
A brief intro is always great. It's Helps people to identify your company.
Address
[email protected]
800-555-0101
yoursite.com