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.
 
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
   
Small Business Enterprise:
Minority Owned Business Enterprise:
Minority Classification:
Women Owned Business Enterprise:
Small disadvantaged Business Enterprise:
   
Business Information
 
Annual Sales (in thousands) - 1yr:
Annual Sales (in thousands) - 2yr:
Annual Sales (in thousands) - 3yr:
Year established:
Fed Tax ID (SS number if no Fed Tax ID):
NAICS:
SIC Code:
EDI:
Total employees:
Full time employees:
Seasonal employees:
Minority employees:
Female employees:
Workers' Comp Insurance:
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 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 Company:
Insurance Company Address:
Insurance Agent Name:
Phone:
Email:
   
Business Capabilities
   
Company Category:
Vendor Type:

Contractor Type:

Professional Service:

Non-Professional Service:

Consulting Type:

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):