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Certifying Authority: (Items in red are required) Certification Application Information St:        Are you a subsidiary of another company? Owner / Partner / CEO Name:Annual Revenue:Legal Entity Type:# of Employees:Company Information 999-999-9999 999-999-9999Fax: Are you a certified SBE?Are you a certified Minority/Woman/Veteran owned business? Check all that apply.Small Business and Minority Status (not required)Contact Name: Choose Your Specialty/IndustryProfessional Services/Consulting Classification (If applicable):   Secondary ContactEmail: Phone: Contact Name:  Primary ContactEmail: Solicitation Opportunity Registration       Name and AddressZip: Address 2: Address 1: Company Name: City:      

 

 

 

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