Please enter a company name. Please enter an address. Please enter a city. Please enter a state. Please enter a zip code. Please enter a contact name. Please enter an email address. Please enter a contact phone. Thank you for submitting your registration. We will contact you as soon as possible. Legal Terms of Registration The information provided is used to identify potential suppliers for contract opportunities. Please ensure that the information on your company is kept up-to-date. Registration does not guarantee any business enterprise the right to bid or receive a contract. * Required Field Company Name* Doing Business As Address* City* State* ---ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip* Website URL Dun and Bradstreet Number EIN* Primary NAICS Code Contact Name* Email* Contact Phone* SpecialtyDetailed Description of product/services provided: History*Have you worked with POWER Engineers before? YesNo If yes, please provide the Contract Number: ReferenceHow did you hear about POWER Engineers? Name of POWER employee that referred you Which POWER capability are you interested in?---Power DeliveryPower GenerationFood & BeverageFacilitiesCommunicationsEnvironmentGeospatial & Asset ManagementInternationalFederalMicrogrid StationOil & Gas BackNext Federal Programs (FAR Part 19 & 26) Is your firm registered with the System for Award Management (SAM) or SBA's (DSBS) Dynamic Small Business Search?*YesNo Has your firm completed Online Representation and Certifications Applications (ORCA) at SAM? YesNo Is your firm a Small Business? YesNo Is your firm a Small Disadvantaged Business?YesNo Is your firm an 8(a) Small Disadvantaged Business*? YesNo Is your firm a Woman-owned Small Business? YesNo Is your firm a Veteran-owned Small Business? YesNo Is your firm a Service-disabled Veteran-owned Small Business? YesNo Is your firm a HUBZone Small Business*? YesNo Is your firm an Alaskan Native Corporation or member of a recognized Indian Tribe? YesNo *8(a) SDB and HUBZone must be certified by SBA BackNext Unified Certification Programs (49 CFR 26) Is your firm certified as a socially and economically Disadvantaged Business Enterprise (DBE) through a statewide Unified Certification Program (UCP)? List each UCP *YesNo Certified As(Check all that apply): Minority Business Enterprise (MBE)Woman Business Enterprise (WBE) State: ---ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Certifying Agency or Organization: Certification No. State: ---ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Certifying Agency or Organization: Certification No. State: ---ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Certifying Agency or Organization: Certification No. Additional Certifications Does your firm hold other certifications (including municipal, regional, and third party)? YesNo * Including VBE and DSVBE certifications Certification---Minority Business EnterpriseWoman Business EnterpriseVeteran Business EnterpriseService Veteran Business EnterpriseLGBTOther If other: State/Council Membership No. Certification---Minority Business EnterpriseWoman Business EnterpriseVeteran Business EnterpriseService Veteran Business EnterpriseLGBTOther If other: State/Council Membership No. Certification---Minority Business EnterpriseWoman Business EnterpriseVeteran Business EnterpriseService Veteran Business EnterpriseLGBTOther If other: State/Council Membership No. Additional Information Number of Employees at your firm Average Annual Revenue Year Established Organization Classification---Individual proprietor or single-member LLCC CorporationS CorporationPartnershipTrust/estateLLC C CorporationLLC S CorporationLLC PartnershipOther If other Under penalties of perjury, I certify that the information provided on this form is accurate and true to the best of my knowledge. (Pursuant to 15 U.S.C 645(d)) Contact supplierdiversity@powereng.com with questions or any additional information.