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Facility Information


*Required Entries (this information will not be saved unless the "Save" button below is pressed)
 *Facility Name: 
Supplemental Name: 
*Phone:   -  (e.g. 502 111-2222)
Fax:  -
Company Web Site: 
D&B D-U-N-S Number: 

Location
 *Street Address: 
 *City / State / Zip:   
 *County: 

Mailing Address (if different from Location)
Address: 
City / State / Zip:   

Business Description
  *Description of products and/or services - 500 character limit
  
  Description of capabilities (i.e., what your business can do) - 500 character limit
  
  Special Equipment / Services / Processes (i.e., make, model, capacity - output unit/time, etc.) - 500 character limit
  
  Special Certifications (e.g., ISO, QS, HUBZone, MBE, WBE, etc.) - 500 character limit
  

Contacts for New Business Inquiries
Primary Contact (required) Secondary Contact (optional)
 *Name: 
 *E-Mail: 
Name: 
 E-Mail: 
(E-mail addresses will be used to forward requests to you for additional information, but will not be displayed to site visitors)

Activities
The list of NAICS codes can be found at http://www.census.gov/epcd/naics02/naico602.htm   
Rank NAICS Code (6 digits)
1:  
2:  
3:  
4:  
5:  
6:  
List and rank in order of importance (1 being most important) the primary activities (up to 6) in which the facility is engaged.

Registrant Details
 *Registrant Name: 
 *Registrant E-Mail Address: 
 *Password:  (at least 6 and no more than 15 characters) 
Date of Initial Registration:  Thursday, August 21, 2008
 
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