vendorProfile.pdf

This is a Vendor Profile form used for state and local contract opportunities to collect standardized identification and business information from prospective vendors. The form captures essential vendor identification details including CEO name, contact person, business name, and Federal Identification Number or Social Security Number, along with primary headquarters and local branch business addresses and phone numbers. The form requests business establishment dates, current ownership establishment dates, total sales from the last fiscal year across multiple ranges (under $25,000 to over $500,000), and employee count categories (under 10 to over 100). Additionally, the form identifies the type of business activity, with options including construction, professional services, maintenance services, manufacturing, retail sales, and other categories.

The Vendor Profile form includes a section for vendors to self-identify ownership structure and diversity status, allowing vendors to indicate if their company is at least 51 percent owned, controlled, and actively managed by Vietnam Era Veterans (1964-1973), women, handicapped persons, Black Americans, Native American Indians, Hispanic Americans, Asian Pacific Americans, Cape Verdeans, or Asian Indian Americans. The form requires certification by a corporate official through signature and date, establishing accountability for the accuracy of the information provided. This document serves as a foundational questionnaire for vendor qualification and potential set-aside eligibility determination in state and local procurement processes.