Input form
Please complete all applicable information requested below and submit your form. Your information will be reviewed and you will be contacted if additional information is required before your profile is added to our supplier database.
Please note:  1. Please click on the question marks for instructions on valid field information.
                          2. All fields that are in BOLD are required fields.
                          3. Please allow approximately 15 minutes to complete this form.
 
Contact Information  
 
Company Name:
DBA:
Street Address:
City:
State:
Zip:
   
Contact Name:
Phone:
Fax:
Email:
Website:
   
Business Classification  
Check all boxes that apply to your business
   
Company Category:
Small Business Enterprise:
Minority Owned Business Enterprise:
Minority Classification:
Women Owned Business Enterprise:
Small disadvantaged Business Enterprise:
   
Business Information  
 
Annual Sales (in thousands) - Previous Yr.:
Annual Sales (in thousands) - 2 Yrs. ago:
Annual Sales (in thousands) - 3 Yrs. ago:
Year established:
Federal Tax ID:
NAICS:
Total employees:
Full time employees:
Seasonal employees:
Minority employees:
Female employees:
Workers' Comp Insurance:
Accept Credit Cards?:
Payment Terms:
Geographic Service Area
 
Bank Information  
 
Company Bank 1:
Company Bank Address (Street, City, State, Zip):
Bank Contact 1 Name:
Phone:
Email:
   
Company Bank 2:
Company Bank Address (Street, City, State, Zip):
Bank Contact 2 Name:
Phone:
Email:
   
Bond Information  
Bond Agent License in OH:
Bonding Capacity (overall $):
Bonding Capacity (per instance $):
Bonding Company:
Bonding Company Address (Street, City, State, Zip)
Professional Errors and Omissions ($):
Bond Agent Name:
Phone:
Email:
   
Insurance Information  
Insurance Company:
Insurance Company Address:
Insurance Agent Name:
Phone:
Email:
   
Business Capabilities  
   
Goods Type:

Contruction Type:

Professional Service:

Non-Professional Service:

Service/Product Details
(Type your information here):
Business Certifications:
(Please list all certifications and also send all hard copies to: Cincinnati Public Schools, Supplier Diversity Office, Education Center PO Box 5384, Cincinnati, OH 45201-5384)
Professional Licenses and Certifications:
Please list all certifications and also send all hard copies to: Cincinnati Public Schools, Supplier Diversity Office, Education Center PO Box 5384, Cincinnati, OH 45201-5384)
   
Ownership Information  
   
Principal Owner 1 Name:
Owner 1 Title:
% Ownership:
Minority % Ownership:
US Citizen:
Owner 1 CPS Grad School, Year:
   
Principal Owner 2 Name:
Owner 2 Title:
% Ownership:
Minority % Ownership:
US Citizen:
Owner 2 CPS Grad School, Year:
   
Principal Owner 3 Name:
Owner 3 Title:
% Ownership:
Minority % Ownership:
US Citizen:
Owner 3 CPS Grad School, Year:
   
References  
 
Non CPS References (Name, Street Address, City, State, Zip, Phone, E-mail):
(Include the Type/Work Performed and the Contract or Project dollar value for each reference)
CPS References (Name, Phone, E-mail):