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Purchasing Department - University of Connecticut

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Section 10<br />

Vendors Qualification Statement<br />

All vendors are required to file this form, properly completed, WITH THEIR RESPONSE. Failure <strong>of</strong> a<br />

vendor to answer any question or provide required information may be grounds for the awarding authority<br />

to disqualify and reject their proposal. If a question or request for information does not pertain to your<br />

organization in any way, use the symbol "NA" (Not Applicable). Use additional 8 1/2" x 11" sheets with<br />

your letterhead as necessary.<br />

1. Indicate exactly the name by which this organization is known:<br />

Name .<br />

2. How many years has this organization been in business under its present business name?<br />

Years? .<br />

3. Indicate all other names by which this organization has been known and the length <strong>of</strong> time known<br />

by each name:<br />

1. ______________________<br />

2. ___________________________________________________<br />

3. ___________________________________________________<br />

4. What is the primary commodity/service provided by this business? How many years has this<br />

organization been in business providing this commodity/service?<br />

Commodity/Service<br />

____________________________<br />

Years? __________________<br />

How many years in the Visual Enhancement Services Business? ________<br />

5. This firm is a: Corporation Partnership _________Sole Proprietorship<br />

Joint Venture<br />

Other<br />

_______Women Owned _______Minority Business ________Set Aside Contractor<br />

Page 1 0F 3<br />

58

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