LIVE: Michels: Supplier Diversity

Company Information
Legal Company Name
DBA/AKA Name
Contact Name
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Physical Address
City
State
Zip
Is the mailing address the same as the physical address?
Mailing Address
City
State
Zip
Website
Owner's First Name
Owner's Last Name
Owner's Email
Federal Tax ID Number
D&B Number
Parent Company Affiliation
Annual Revenue
Number of Employees
Primary NAICS Codes
Additional NAICS Codes
Are you bonded?
What is your project capacity?
What is your aggregate?
How long have you been in a relationship with your surety?
Upload a Good Guy Letter (optional)

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Are you affiliated with any unions?
Please list the names and locations of the union(s) you are affiliated with.
Geographic Coverage

Other
Diverse Business Classification
Upload Diverse Business Certificate

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Certified by an NMSDC Affiliated Council? If yes, enter your Certificate Number and Expiration Date.
Upload NMSDC Affiliated Council Certificate

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Certified by the WBENC? If yes, enter your Certificate Number and Expiration Date.
Upload WBENC Certificate

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If you are certified by another agency or are indigenous and/or tribally owned, enter the name of each agency and/or tribal affiliation and the corresponding certificate number(s) and expiration date(s) here. (One per line).
Upload Other Certificates and/or Tribal Cards

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Upload SOQ/Capability Statement

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Federal Contracting Information
Unique Entity ID
Please identify any federal small business classifications your company self-certifies under.

A small business is a business that self-certifies as small under the size standards established by the U.S. Small Business Administration (SBA). Business size is determined by the applicable NAICS code and is generally based on either the number of employees or average annual receipts. For more information, please refer to www.sba.gov/size.
Please check all that apply.
Please indicate your organization’s current CMMC level and assessment status. Select the option that best applies.
Upload SBA Certificate

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Other
Have you been involved in a Mentor Protégé (MPP) relationship?
Have you been involved in a Joint Venture (JV) relationship?
Have you worked with Michels previously?
Please list the Project(s), Bids, and Michels point of contact(s).
Ability to prime federal contracts?
Please list past projects.
Is your entity or any of its principals currently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any federal agency?
Has your company failed to complete a project?
Please explain why.
Has your company received any OSHA citations in the last three years?
Please explain the citations.
Is there anything else you'd like us to know?
How did you hear about us?
Acknowledgement

The undersigned declares the above statements are true and correct.

IMPORTANT NOTICE: Under 15 U.S.C. 645(d), any person who misrepresents a firm's size or disadvantaged status in order to obtain a federal contract or subcontract shall (1) be punished by imposition of a fine, imprisonment, or both; (2) be subject to administrative remedies; and (3) be ineligible for participation in programs conducted under the authority of the Small Business Act.
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Company Information

Federal Contracting Information

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Acknowledgement