Supplier Diversity

Supplier Profile

The information requested below must be complete in order to process your profile. Please verify the contact information you provide and include an e-mail address.

When your profile is received you will be notified via e-mail.

Are you filling out a new or updated Supplier Profile?
New Profile Updated Profile
   
Company Name:

Owner Salutation:
Owner's Name:
First Last Middle
Owner's Title:
 
Is Contact Information same as Owner Information?
Contact Salutation:
Contact Person:
First Last Middle
Contact's Title:
   
Physical Address:
Suite:
City:
State:
County: (Ex. Tarrant)
ZipCode: -
   
Is Mailing Address same as Physical Address?
Mailing Address:
Suite:
City:
State:
County: (Ex. Tarrant)
ZipCode: -
   
Telephone Number: ( )- - ext.
Fax Number: ( )- -
Toll Free: ( )- -
Toll Free Fax: ( )- -
Web Site:
Email:
   
Type of Organization:

Select the category that best describes your business. If you select both commodity and services, please specify your "Primary" category.

Note the category you select may also require a sub-category selection.
Main Commodity:
Sub Commodity:
Main Service:
Sub Service:
   
If you have selected both commodity and service, please specify your 'Primary' category.
CommodityService
   
Based on Small Business Administration Standards (www.sba.gov/size/), the company is:
(Contact SBA at 1-800-8ASK-SBA)
   
1)
Small Business
Large Business
 

If "Small Business" are you:

Veteran Owned
Service-Disabled Veteran Owned
 
2) Certified as Small Disadvantaged Business?
Yes
No
If yes, Expiration Date of Certification: (mm/dd/yyyy)
 
3) Certified as HUBZONE by SBA?
Yes
No
 
4) Historically Black College/University or Institution?
Yes
No
 
5) Please use the following link to find your appropriate NAICS code.

North American Industrial Code System (NAICS code):
 
   
Have you ever done business with Energy Future Holdings?
Yes
No
  If Yes when? (Year only)
 
Do you accept MasterCard?
Yes No
 
In order to qualify as a M/WBE, the company must be 51% owned, operated and controlled by a minority(s) or woman/women. Please check the appropriate classification.
   
African American Male Hispanic Male
African American Female Hispanic Female
Asian Indian American Male Native American Male
Asian Indian American Female Native American Female
Asian Pacific American Male White Female
Asian Pacific American Female White Male
   
If you have been certified by a Minority Business Enterprise, Woman Business Enterprise, or Small Disadvantaged Business certifying agency, please complete the following by filling in the appropriate agency(ies) and certification expiration date(s).
 
 
Agency's Name:
1)
If Other then list the agency's name.
Expiration Date:
2)
If Other then list the agency's name.
Expiration Date:
3)
If Other then list the agency's name.
Expiration Date:
4)
If Other then list the agency's name.
Expiration Date:
A copy of your M/WBE certification(s) must be received within 30 days in order to complete the process for inclusion in the Supplier Diversity Directory. Please forward your information to fax number 214.875.9042 or mail to Energy Future Holdings, Attn: Supplier Diversity, 500 N. Akard Street, Suite 10-015B, Dallas, TX 75201.
 
Information prepared by:
Name: Date: 11/21/2009 12:59:41 PM
Title:
 
Under 15 U.S.C. 645(d), any person who misrepresents a firm's status as a small or small disadvantaged business concern in order to obtain a contract to be awarded under the preference programs established pursuant to section 8(a), 8(d), 9, or 15 of the Small Business Act or any other provision of Federal law that specifically references 8(d) for a definition of program eligibility, shall (i) Be punished by imposition of fine, imprisonment, or both; (ii) Be subject to administrative remedies, including suspension and debarment; and (iii) Be ineligible for participation in programs conducted under the authority of the Act.
 
Please check this if you have read and understand the 15 U.S.C. 645(d) clause.