NAME OF
COMPANY:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

ADDRESS:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

ADDRESS:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

CITY:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

STATE:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ ZIP
CODE:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TELEPHONE
NUMBER:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TAX IDENTIFICATION
NUMBER:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

INFORMATION ABOUT COMPANY:

Is the company:

YES NO

\_\_\_ \_\_\_\_ Small Business

(The term \"Small Business\" means a concern, including its affiliates,
which is independently owned and operated, is not dominant in the field
of operation in which it is bidding on Government Contracts, and can
further qualify under the criteria set forth in the regulations of the
Small Business Administration (13 CFR 121.3-8).)

\_\_\_ \_\_\_\_ Minority Owned

\_\_\_ \_\_\_\_ Women Owned

PLEASE CHECK EACH STATE IN WHICH YOU WISH TO PERFORM WORK:

\_\_\_\_ All States \_\_\_\_ AL Alabama \_\_\_\_ AR Arkansas

\_\_\_\_ FL Florida \_\_\_\_ GA Georgia \_\_\_\_ KY Kentucky

\_\_\_\_ LA Louisiana \_\_\_\_ MS Mississippi \_\_\_\_ NC North Carolina

\_\_\_\_ SC South Carolina \_\_\_\_ TN Tennessee

\_\_\_\_ PR Puerto Rico \_\_\_\_ VI Virgin Islands

**Please check the desired type(s) of work:\
**

DIVISION A-AGRICULTURE, FORESTRY AND FISHING

Major Group 08-Forestry

\_\_\_\_\_ 0851 Forestry Services

\_\_\_\_\_ Miscellaneous:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

DIVISION B-MINING

Major Group 14-Mining and Quarrying of Nonmetallic Minerals, Except
Fuels

\_\_\_\_\_ 1442 Construction Sand and Gravel

\_\_\_\_\_ 1449 Miscellaneous Nonmetallic Minerals, Except Fuels

DIVISION C-CONSTRUCTION

Major Group 15-Building Construction-General Contractors and Operative
Builders

\_\_\_\_\_ 1521 General Contractors-Single Family Houses

\_\_\_\_\_ 1522 General Contractors-Residential Buildings, Other than
Single Family

\_\_\_\_\_ 1541 General Contractors-Industrial Buildings and Warehouses

\_\_\_\_\_ 1542 General Contractors-Nonresidential Buildings, Other than
Industrial

Buildings and Warehouses

\_\_\_\_\_
Miscellaneous:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Major Group 16-Heavy Construction Other than Building Construction
Contractors

\_\_\_\_\_ 1611 Highway and Street Construction, Except Elevated
Highways

\_\_\_\_\_ 1622 Bridge, Tunnel, and Elevated Highway Construction

\_\_\_\_\_ 1623 Water, Sewer, Pipeline, and Communications and Power
Line Construction

\_\_\_\_\_ 1629 Heavy Construction, Not Elsewhere Classified (N.E.C.)

Major Group 17-Construction, Special Trade Contractors

\_\_\_\_\_ 1711 Plumbing, Heating and Air-Conditioning

\_\_\_\_\_ 1721 Painting and Paper Hanging

\_\_\_\_\_ 1731 Electrical Work

\_\_\_\_\_ 1751 Carpentry Work

\_\_\_\_\_ 1752 Floor Laying and Other Floor Work, N.E.C.

\_\_\_\_\_ 1761 Roofing, Siding, and Sheet Metal Work

\_\_\_\_\_ 1771 Concrete Work

\_\_\_\_\_ 1781 Water Well Drilling

\_\_\_\_\_ 1791 Structural Steel Erection

\_\_\_\_\_ 1794 Excavation Work

\_\_\_\_\_ 1795 Wrecking and Demolition Work

\_\_\_\_\_ 1796 Installation of Erection of Building Equipment, N.E.C.

\_\_\_\_\_ 1799 Special Trade Contractors, N.E.C.

DIVISION D-MANUFACTURING

Major Group 25-Furniture and Fixtures

\_\_\_\_\_ 2521 Wood Office Furniture

\_\_\_\_\_ 2522 Office Furniture, Except Wood

\_\_\_\_\_ 2531 Public Building and Related Furniture

\_\_\_\_\_ 2599 Furniture and Fixtures, N.E.C.

Major Group 27-Printing, Publishing and Allied Industries

\_\_\_\_\_ 2711 Newspapers; Publishing, or Publishing and Printing

\_\_\_\_\_ 2721 Periodicals: Publishing, or Publishing and Printing

\_\_\_\_\_ 2731 Books, Publishing, or Publishing and Printing

\_\_\_\_\_ 2741 Miscellaneous Publishing

Major Group 30-Rubber and Miscellaneous Plastic Products

\_\_\_\_\_ 3011 Tires and Inner Tubes

\_\_\_\_\_ Miscellaneous:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Major Group 33-Primary Metal Industries

\_\_\_\_\_ 3317 Steel Pipe and Tubes

\_\_\_\_\_
Miscellaneous:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Major Group 34-Fabricated Metal Products, Except Machinery and
Transportation Equipment

\_\_\_\_\_ 3433 Heating Equipment, Except Electric and Warm Air Furnaces

\_\_\_\_\_ 3441 Fabricated Structural Metal

\_\_\_\_\_ 3442 Metal Doors, Sash, Frames, Molding and Trim

\_\_\_\_\_ 3449 Miscellaneous Structural Metal Work

\_\_\_\_\_ 3482 Small Arms Ammunition

\_\_\_\_\_ 3484 Small Arms

\_\_\_\_\_ Miscellaneous:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Major Group 35-Industrial and Commercial Machinery and Computer
Equipment

\_\_\_\_\_ 3523 Farm Machinery and Equipment

\_\_\_\_\_ 3524 Lawn and Garden Tractors and Home Lawn and Garden
Equipment

\_\_\_\_\_ 3531 Construction Machinery and Equipment

\_\_\_\_\_ 3537 Industrial Trucks, Tractors, Trailers and Stackers
(Forklifts)

\_\_\_\_\_ 3561 Pumps and Pumping Equipment

\_\_\_\_\_ 3571 Electronic Computers

\_\_\_\_\_ 3572 Computer Storage Devices

\_\_\_\_\_ 3575 Computer Terminals

\_\_\_\_\_ 3577 Computer Peripheral Equipment, N.E.C.

\_\_\_\_\_ 3585 Air-Conditioning and Warm Air Heating Equipment and
Commercial and

Industrial Refrigeration Equipment

\_\_\_\_\_ Miscellaneous:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Major Group 36-Electronic and Electrical Equipment and Components,
Except Computer Equipment

\_\_\_\_\_ 3621 Motors and Generators

\_\_\_\_\_ 3629 Electrical Industrial Apparatus, N.E.C.

\_\_\_\_\_ 3648 Lighting Equipment, N.E.C.

\_\_\_\_\_
Miscellaneous:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Major Group 37-Transportation Equipment

\_\_\_\_\_ 3732 Boat Building and Repairing

\_\_\_\_\_ 3795 Tanks and Tank Components (Fish Distribution Tanks)

\_\_\_\_\_ 3799 Transportation Equipment, N.E.C. (All Terrain Vehicles)

DIVISION F-WHOLESALE TRADE

Major Group 50-Wholesale Trade-Durable Goods

\_\_\_\_\_ 5014 Tires and Tubes

\_\_\_\_\_ 5032 Brick, Stone, and Related Construction Material

\_\_\_\_\_ 5033 Roofing, Siding, and Insulation Materials

\_\_\_\_\_ 5044 Office Equipment

\_\_\_\_\_ 5045 Computers and Computer Peripheral Equipment and Software

\_\_\_\_\_ 5046 Commercial Equipment, N.E.C

\_\_\_\_\_ 5063 Electrical Apparatus and Equipment, Wiring Supplies, and
Construction Materials

\_\_\_\_\_ 5072 Hardware

\_\_\_\_\_ 5074 Plumbing and Heating Equipment and Supplies (Hydronics)

\_\_\_\_\_ 5075 Warm Air Heating and Air-Conditioning Equipment and
Supplies

\_\_\_\_\_ 5084 Industrial Machinery and Equipment

\_\_\_\_\_ 5099 Durable Goods, N.E.C.

Major Group 51-Wholesale Trade-Nondurable Goods

\_\_\_\_\_ 5111 Printing and Writing Paper

\_\_\_\_\_ 5112 Stationery and Office Supplies

\_\_\_\_\_ 5146 Fish and Seafood

\_\_\_\_\_ 5159 Chemical and Allied Products, N.E.C.

\_\_\_\_\_ 5192 Books, Periodicals and Newspapers

\_\_\_\_\_ 5198 Paints, Varnishes and Supplies

\_\_\_\_\_ 5199 Nondurable Goods, N.E.C.

DIVISION G-RETAIL TRADE

Major Group 52-Building Materials, Hardware, Garden Supply, and Mobile
Home Dealers

\_\_\_\_\_ 5211 Lumber and Other Building Materials Dealers

\_\_\_\_\_ 5261 Retail Nurseries, Lawn and Garden Supply Stores

Major Group 57-Home Furniture, Furnishings and Equipment Stores

\_\_\_\_\_ 5713 Floor Covering Stores

DIVISION H-FINANCE, INSURANCE AND REAL ESTATE

Major Group 63-Insurance Carriers

\_\_\_\_\_ 6361 Title Insurance

DIVISION I-SERVICES

Major Group 73-Business Services

\_\_\_\_\_ 7338 Secretarial and Court Reporting Services

\_\_\_\_\_ 7353 Heavy Construction Equipment Rental and Leasing
(Dragline/Excavator/Backhoe)

\_\_\_\_\_ 7349 Building Cleaning and Maintenance Services, N.E.C.

\_\_\_\_\_ 7359 Equipment Rental and Leasing, N.E.C.

\_\_\_\_\_ 7361 Employment Agencies

\_\_\_\_\_ 7378 Computer Maintenance and Repair

\_\_\_\_\_ 7389 Business Services, N.E.C.

Major Group 87-Engineering, Accounting, Research, Management, and
Related Services

\_\_\_\_\_ 8711 Engineering Services

\_\_\_\_\_ 8712 Architectural Services

\_\_\_\_\_ 8713 Surveying Services

Major Group 89-Services, Not Elsewhere Classified

\_\_\_\_\_ 8999 Services, N.E.C. (Aerial Burning, Timber Cruises,
Appraisals)

Work Not Elsewhere Classified:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_