Potential Supplier Assessment Application
COMPANY INFORMATION
Company Name
Address
City, State
Zip Code
A value is required.
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Phone
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Fax
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Website
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A value is required.
Cage Code
NAICS Code
TYPE OF SUPPLIER
Cable/Wire
Calibration Lab
Casting/Forging
Chemical Films
Contract Manufacturer
Electronic Distributor-Authorized
Hardware
Electronic Manufacturer
Electronic Distributor-Broker
Machine Shop
O-Ring/Gasket
PCB Fabricator
Raw Material-Metal
Raw Material-Plastic
Sheet Metal
Stamping
Testing Lab
Other: Please Specify
SYSTEM APPROVALS
AS9100
ISO 9001
MIL-Q-9858
Other: Please Specify
TYPE OF COMPANY
Large
Small
Small Disadvantaged
Women Owned
Veteran Owned
Service Disabled Veteran Owned
Hub Zone
HBCU / MI
Alaska Native Corp
Native American Tribe
CONTACT INFORMATION
Completed By
Name
Phone
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Email
A value is required.
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Primary Point of Contact
Name
Phone
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Email
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Senior Company Official
Name
Phone
Invalid format.
Email
Invalid format.
Quality Assurance Contact
Name
Phone
Invalid format.
Email
Invalid format.