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About PJM

Prospective Supplier Questionnaire

* Required

Contact Information

* First name:

* Last name:

Title:

* Email:

* Confirm email:

* Company:

If your company is not in the list above, please select 'Other' and enter the appropriate name.

* Other (please specify):

* Country:

* Address line 1:

Address line 2:

* City:

* State:

Zip code:

* Province/Territory:

* Postal code:

* Address:

* Phone:

Fax:

Website:

Please provide information about the PJM employee with whom you have been in contact:

* First name:

* Last name:

* Phone:

* Email:

Comments:

Business Information

* Tax ID number:

Annual Sales $:

For the year:

Projected Sales $:

Service area:

Year established:

Structure:

Parent company:

* Incorporated:

Incorporated state:

Total employees

Principal products or services:

SIC code:

NAICS code:

DUNS number:

Credit Information

* Is the company listed with a business reporting service such as Dun and Bradstreet?

* Please provide the appropriate reference number:

Please provide, separately, financial results information from the past three years.

Please provide, separately, a copy of a current SAS 70 audit, if one exists.

Provide up to three credit references that PJM can contact:

Reference 1

Name:

Phone:

Reference 2

Name:

Phone:

Reference 3

Name:

Phone:

Customers

Please list up to three major customers that you do regular business with:

Customer 1

Name:

Contact:

Phone:

Customer 2

Name:

Contact:

Phone:

Customer 3

Name:

Contact:

Phone:

Business Classification

Company status:

Citizenship:

Gender:

Ethnicity:

Disabled/Veteran:

If the company is a public entity, list the names of up to five principal owners:

Owner 1

Name:

Owner 2

Name:

Owner 3

Name:

Owner 4

Name:

Owner 5

Name:

Has your company been certified by a regional NMSDC/WBENC purchasing council? If so, please list:

Council:

Number:

Date:

Have other agencies certified your firm as a minority, female or disadvantaged business enterprise? If so, please list:

Agency:

Number:

Date:

About PJM

Prospective Supplier Questionnaire

Contact Information

Business Information

Credit Information

Customers

Business Classification

Confirmation