SBE APPLICATION

This form is the SBE Certification application for bidders of awards $50,000 or less.
Click here to see Application Instructions

Company/Organization Information

COMPANY NAME:	FED TAX ID:	No. Yrs in Business:	COUNTY:
Owner 1 FirstName:	Owner1LastName:	Owner1Title:	Contact Person:
Owner 2 FirstName:	Owner2LastName:	Owner2Title:	Contact Person:
Owner 3 FirstName:	Owner3LastName:	Owner3Title:	Contact Person:
Owner 4 FirstName:	Owner4LastName:	Owner4Title:	Contact Person:

Address:

City:

State:

Zipcode

Business Phone:

Business Fax:

Email Address:

Business Structure:

Type of Business:

If Supplier Please Specify Type:

**** If type of business is Manufacturing Rep or Distributor please provide a copy of Agreement with Notary Page. ***

Product or Service Provided:

Technical/Trade Qualifications: Technical/Trade Qualifications, Certification or Special Equipment (please provide copy of License with Notary Page):

Tell us your References

Business History Experience (Provide at least (3) contracts with any company your firm has received.)

Business History Experience 1

Company:

Address:

Telephone No:

Amount$:

Product/Services Provided to company:

Business History Experience 2
Company:	Address:	Telephone No:	Amount$:

Product/Services Provided to company:

Business History Experience 3
Company:	Address:	Telephone No:	Amount$:

Product or Service Provided:

Certifications

Please check below the type(s) of certifications(s) the business is currently certified. ***

SBE 8a Certified

ORV/WBE

Disadvantaged Business(DBE)

WBENC

State of Ohio - MBE

State of Ohio - EDGE

South Central Ohio(MSDC)

Other

Include a copy of current certificate(s) or letter(s) of certification with Notary Page

Submit your Data to Us

SBE - Business Application submission by your company

Select Citizenship:
Race:
Gender

Please note that Race and Gender information is collected for informational purposes only and is given voluntarily

City of Cincinnati