Supplier Information Form

Indicate whether you are a Potential or Current DRS Technologies supplier:

Potential Supplier

Current or Former Supplier

Enter Company Information:

Identify Company Contact:

Specify Company Details:

Other Government Agency Customers:

Specify Business Classification:
(Check All That Apply)

(LB) Large Business Concern

(WOLB) Women-Owned Large Business

(VOLB) Veteran-Owned Large Business

SBA-Certified Small Disadvantaged Business Concern (Dates mandatory if selected):

SDB Entrance Date (mm/dd/yy):
SDB Entrance Date (mm/dd/yy):

Self-Certified Small Disadvantaged Business Concern

Women Owned Small Business Concern

Historically Black College or University

Minority Institution

SBA-Certified HUBZone Small Business Concern (Dates mandatory if selected):

SDB Entrance Date (mm/dd/yy):
SDB Entrance Date (mm/dd/yy):

Veteran Owned Small Business Concern

Native American Owned

Indian Tribe Owned

Ability One

Foreign Owned

Certification:

The undernamed certifies that the above named company maintains a business classification as indicated above and that such classification is in accordance with all regulatory requirements related thereto. Further, it is understood and agreed that misrepresentation of the business classification is subject to penalties as prescribed in FAR 52.219-1.

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