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In support of the Supplier Diversity Programs of our clients, we are required to maintain certification of Business Size and Ownership from all of our suppliers/vendors/partners. Your participation in reporting this information is important for ensuring successful relationships among all members of the business community. Our entire supplier base, regardless of size or ownership, is encouraged to actively support our Supplier Diversity initiatives.

Instructions to complete the supplier diversity form

* Required Fields

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Section A: Business Size*
Select the classification of your business: (Contact the nearest U.S. Small Business Admin.office (SBA) for guidance if you have questions) – Please check one:

Business Size

Section B: Organization/Ownership*
Please check all that apply (If any of the below are checked, please attach a copy of the approved certificates, otherwise mark as self-reported.)

Organization/Ownership

Section C: Minority Groups*
Minority-Owned Business (A for-profit business that is at least 51% owned by one or more of the following ethnic minorities who control daily management of business.)

Minority Groups
Certification Type
Certifying Organization Name

This will certify that the classifications I have selected are true and correct. Under 15 U.S.C. § 645 (d), any person who misrepresents the status of any concern or person may (1) be subject to a fine, imprisonment, or both; (2) be subject to administrative remedies; and (3) be ineligible for participation in programs conducted under the authority of the Small Business Act.*

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