Prospective supplier form

If you are interested in providing products and/or services to ATC, please complete and submit the form below. In addition:

Supplier Diversity Information

Supplier Profile Questionnaire

E-mail a signed copy of Supplier Profile Questionnaire and your company W9

You will receive an electronic response confirming receipt of your information.

Please note that submitting your form does not guarantee an opportunity to compete for business, imply a contract or an intent to purchase by American Transmission Co.

Thank you for your interest.

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Company Address and Contact Information

Company(Required)

Job Title(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Fax

Website

Business Ownership Classification

Organization Type(Required)

Federal Taxpayer ID#(Required)

(##-#######)

Product and Services Description: (enter at least one)(Required)

To see a full listing of supplier categories, please view this PDF.

List primary products and/or services you offer:

Annual Sales

Year 1(Required)

Year 1 Amount(Required)

Year 2(Required)

Year 2 Amount(Required)

Year 3(Required)

Year 3 Amount(Required)

List your top three customers by dollar volume, including references and phone numbers.

Customer 1

Customer 1 Name(Required)

Customer 1 Reference(Required)

Customer 1 Phone(Required)

Customer 2

Customer 2 Name(Required)

Customer 2 Reference(Required)

Customer 2 Phone(Required)

Customer 3

Customer 3 Name(Required)

Customer 3 Reference(Required)

Customer 3 Phone(Required)

Union Affiliated?(Required)

Yes

Year Established(Required)

Number of Employees(Required)

I accept and certify that this information is true to the best of my knowledge.(Required)

Yes

Note: There are federal penalties for providing false or misleading information as to your firm’s size and business type (supplier/contractor misrepresentation) – Federal Acquisition Regulation (FAR), Section 52.219-1 © and 15 USD 645 (d). If you have any questions and/or need assistance with identifying your business classification, call your local/regional SBA office.

Email a signed copy of your company W-9.

Thank you for your interest in ATC.