HiddenNext Steps: Sync an Email Add-OnTo get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.Business Name(Required) Point of Contact Name (First & Last)(Required) Email Address(Required) Phone NumberUEI # (SAM.gov – Unique Entity Identifier) NAICS Code (North American Industry Classification System)Please use commas for multiple codes. Authorized OEM Reseller for:Please use commas for multiple vendors. Socioeconomic Category Small Business 8(a) Certified AbilityOne Tribally-Owned/Native-Owned Business Historically Underutilized Business Zone (HUBZone) Service-Disabled Veteran-Owned Small Business (SDVOSB) Small Disadvantaged Business (SDB) Veteran-Owned Small Business (VOSB) Woman-Owned Small Business (WOSB) Website Upload your capability statementMax. file size: 400 MB.Industry & Capabilites – Keywords(Required)Example: roofing, insulation, drywall Any Past Performance with SNL, NNSA and/or DOE? Sandia National Laboratories Los Alamos National Laboratory NNSA DOE Headquarters Other Other Past Performance: Do you hold a current Enterprise Wide Agreement? (SCMC, ICPT, etc.) Yes No Please note your Enterprise Wide Agreement Number: Are you a current Protege in a DOE Mentor-Protege Agreement? Yes No Who is your DOE Mentor? When does your Mentor-Protege Agreement end? How did we meet?Check all that apply: Conference Outreach Event One-on-One Meeting with Supplier Diversity Advocate Other Conference Name: Outreach Event Title: Date of One-on-One MeetingMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Other CAPTCHA