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COMPANY INFORMATION
Company Name*
 Email Address*
  
Street Address*
 Suite or unit #
  
City *
 State *
 Zip Code *
Phone*
- - 		Fax
- - 		EIN*
-
Website
 CEO/President
 DUNS No.
 
Annual Sales
$ 		Number of Employees
  
General Product, Line of Business
  
 
Primary NAICS (comma-separated)
 Other NAICS (comma-separated)
  
For NAICS Codes view: http://www.sba.gov/size/indextableofsize.html


FACILITY CLEARANCE   Check all that apply
Secret SCI Other
Top Secret Q Clearance if Other, give type


BUSINESS SIZE
Small Large/Other than Small  


BUSINESS OWNERSHIP   Check all that apply
Minority-Owned Woman-Owned Foreign-Owned
Service-Disabled Veteran Veteran-Owned Foreign-Owned Country
Severely Handicapped Nonprofit  


BUSINESS STATUS   Check all that apply
Minority-Owned Certifying Organization
 Certification Date
  Black American Asian Pacific American
  Native American Subcontinent Asian American
  Hispanic Other
Woman-Owned Certifying Organization
 Certification Date
Small Disadvantaged Business Certifying Organization
 Certification Date
8(a) Certified Certifying Organization
 Certification Date
HUBZone Business Certifying Organization
 Certification Date


CORPORATE CERTIFICATION   Check all that apply
ISO Level
 CMM Level
CMMi Level
 ANSI Level
Other Details


ADDITIONAL DETAILS
Additional company information, certifications, etc... (3,000 character max.)
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PAST PERFORMANCE
Please provide information on up to five contracts indicative of your primary business line.


PAST PERFORMANCE 1
Client
 Contract Title
Contract #
 Performance Period
to
Contact
 Phone Number
- -
Value
$		 Role
Description of Work


PAST PERFORMANCE 2
Client
 Contract Title
Contract #
 Performance Period
to
Contact
 Phone Number
- -
Value
$		 Role
Description of Work


PAST PERFORMANCE 3
Client
 Contract Title
Contract #
 Performance Period
to
Contact
 Phone Number
- -
Value
$		 Role
Description of Work


PAST PERFORMANCE 4
Client
 Contract Title
Contract #
 Performance Period
to
Contact
 Phone Number
- -
Value
$		 Role
Description of Work


PAST PERFORMANCE 5
Client
 Contract Title
Contract #
 Performance Period
to
Contact
 Phone Number
- -
Value
$		 Role
Description of Work




By clicking submit I hereby certify the above provided information is true and accurate. I further certify my understanding that CNSI may rely on such information in arriving at contract decisions.


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