Request for Vendor Information

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VENDOR INFORMATION FORM

Email *

COMPANY NAME: *

MAILING ADDRESS FOR BIDS/PROPOSALS

STREET ADDRESS/PO BOX *

City *

State *

Zip *

TELEPHONE: *

FAX: *

DUNS NUMBER: *

CAGE NUMBER: *

TYPE OF ORGANIZATION

CHECK ALL THAT APPLY

INDIVIDUAL

PARTNERSHIP

CORPORATION

NON-PROFIT CORPORATION

IS THIS A BUSINESS (CHECK ALL THAT APPLY)

MINORITY BUSINESS ENTERPRISE *

YES

SMALL BUSINESS ENTERPRISE *

YES

WOMEN BUSINESS ENTERPRISE *

YES

LABOR SURPLUS FIRM *

YES

SPECIFIC CLASS OF MATERIALS/SERVICES YOU SEEK TO FURNISH

SELECT ALL THAT APPLY *

CONSTRUCTION MONITORING AND PROJECT INSPECTION

POLES AND/OR MATERIALS

PERMANENT REPAIR (LINE CONSTRUCTION)

FIELD DESIGN AND STAKING

ARCHAEOLOGICAL FIELD MONITORING

Required

No Director or employee may solicit or receive gifts, gratuities, entertainment or anything else of significant value given for the purpose of influencing the action of NWEC or of the recipient

PRINTED NAME OF PERSON SIGNING FORM *

TITLE

DATE *

YYYY

If proposal is not received within 1 business day, please contact NWEC at (580) 256-7425

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