*Company Name *Street Street (cont.) *City *State *Zip Code *Phone Fax *Contact Contact Title *Email Website
Business Ownership Classification *Company Status
Foreign Owned Exempt Non-Profit Business Minority Institution (College or University) Historically Black College or University Large Business Small Business Not Classified
* Owner's Citizenship
U.S. Citizen Non-U.S. Citizen
*Gender
Male Owned Business Female Owned Business
*Ethnicity
Non-Minority African American Hispanic American Asian Pacific American Subcontinent Asian American Native American (American Indians, Aleuts, Eskimos, Hawaiians)
*Disabled/Veteran
Disabled American Disabled Veteran Not Classified
Primary NAICS Code
North American Industry Classification System (NAICS) 2002 NAICS Codes and Titles
Secondary NAICS Code
DUNS Number
D-U-N-S NUMBER
Business Information
*Annual Sales $ *For the year Projected Sales $ *Year Established Sq. Ft. Total Sq. Ft. Office Sq. Ft. Warehouse
Structure
Corporation Division Franchise Joint Venture Limited Liability Company (LLC) Partnership Sole Proprietor
Parent Company
Ownership
Publicly Held Privately Held
State of Registration
Total Number of Employees
Number of Minority Employees
*Have you supplied Armstrong in the past?
Yes No
If yes, when?
If yes, which Armstrong location(s)?
Principle Products or Services *Product Type(s)
1) Advertising/Marketing Capital Equipment & Services Energy, Fuel, Utilities & Disposal Information Systems Legal Logistics, Freight, & Transportation Lumber, Veneer & Wood Products MRO Supplies, Materials & Services Packaging Raw Materials Sourced Products Other 2) Advertising/Marketing Capital Equipment & Services Energy, Fuel, Utilities & Disposal Information Systems Legal Logistics, Freight, & Transportation Lumber, Veneer & Wood Products MRO Supplies, Materials & Services Packaging Raw Materials Sourced Products Other 3) Advertising/Marketing Capital Equipment & Services Energy, Fuel, Utilities & Disposal Information Systems Legal Logistics, Freight, & Transportation Lumber, Veneer & Wood Products MRO Supplies, Materials & Services Packaging Raw Materials Sourced Products Other
Comments
Certification Information A) Has your company been certified by any regional NMSDC purchasing council? If so please list.
Council Number Date
B) Has your company been certified by any regional WBENC Partner Organization? If so please list.
Organization Number Date
Organization
C) Has your company been certified by any regional SBA Partner Organization? If so please list.
SBA Certification Number Date
SBA Certification Number
Major Customers That You Do Regular Business With1)
Customer Contact Phone
Customer
2)
3)
Comments (Please limit to 2000 characters.)
