vendorProfile.pdf

This is a Vendor Profile form used by state and local government agencies to collect identification and business information from potential contractors and vendors. The form requests comprehensive details about the vendor's organizational structure, ownership, and business operations to determine eligibility for contract opportunities and potential set-aside programs.

The form captures essential vendor identification including CEO name, contact person, business name, Federal Identification Number or Social Security Number, and both primary headquarters and local branch business addresses with corresponding phone numbers. Business profile information includes the year the business was established, year present ownership was established, total sales from the last fiscal year (with ranges from under $25,000 to over $500,000), and number of employees (ranging from under 10 to over 100). The form also includes checkboxes to identify ownership classifications, including Vietnam Era Veterans, women-owned, handicapped person-owned, and various minority-owned business designations such as Black American, Native American Indian, Hispanic American, Asian Pacific American, Cape Verdean, and Asian Indian American. The form requires certification by a corporate official with printed name, title, signature, and date. Business type classification options include Construction, Professional Service, Maintenance Service, Manufacturing, Retail Sales, and Other.