New Vendor Information Form *Indicates required field. *Registration Date: *Company Name: D/B/A (If applicable); *Business Address: Suite / Floor / PO Box: *Company Phone No.: *City: *State: ---------- Alaska Alabama Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *Zip Code: *Website: Remittance Address (if different than business): Suite / Floor / PO Box: City: State: ---------- Alaska Alabama Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: *Contact Last Name: *First Name: *Title: Office Phone: Mobile Phone: Fax Number: *Federal Tax ID No. (EIN) or Social Security No.: *Email Address: * Individual Sole Proprietor Corporation Partnership Other: *Proof of Insurance (required for service providers) Yes No (NOT APPLICABLE) *What are the main goods/services your Company provides? Your Company is a: Your company provides services/supplies in the field of: Manufacturer Supplier Professional Service Broker Other Services Construction Electrical Plumbing Hardware Building-Maintenance Mechanical Transportation Info Tech. Special Equipment Other: Other: Please list all of your Company's NAICS, NGIP, SIC, CSI and/or UN/SPC Codes: MINORITY/WOMEN BUSINESS ENTERPRISE (MBE/WBE) Is your Company at least 51% Minority-Owned? Yes No Ethnicity of Ownership: African-American Hispanic Asian-American; Is your Company at least 51% Female-Owned? Yes No Is your company certified or pending certification as an MBE or WBE? Yes No Indicate and provide a copy of your MBE/WBE certification. McCormick Place SMG will recognize certification from cities, states, counties and other certification entities that have standardized procedures verifying that a company is 51% owned by a minority or woman. This is subject to review and approval by McCormick Place/SMG. Attach a document (*file must be .docx or .pdf and be 10MB or smaller) Current Bid/Proposals Opportunities About Us Facility Overview Parking Event Calendar Getting Here Event Contractors Green Initiative Arie Crown Theater Savor FedEx Office American Express OPEN Business Lounge