Supplier Registration

• Name of sub-contractor or vendor
• Business address
• Telephone & Fax
• Primary contact name
• Primary contact email
• Primary contact direct phone number
• Type of organizationCorporationLLCPartnershipSole Proprietorship
• Date Company established
• Name of officer or owner
• Federal Employer Identification Number
• Duns/Experian number
• Geographical service area
• Trade/services/ materials provided
• Trade License numbers
• Total number of permanent employees
• Total number of field superintendents
• Are you union or non-union?Yes    No
• Referral #1
• Referral #2
• Referral #3
• Are you a diverse supplier?:Yes    No
• If yes, select the type of diverse supplier:
  
  National Minority Supplier Development Council (NMSDC)The Women’s Business Enterprise National Council (WBENC)Supplier Clearinghouse for the Utility Supplier Diversity Program of the Public Utilities Commission (CPUC)U.S. Business Leadership Network (USBLN)U.S. Department of Veterans Affairs