Collective Number

Bid Description

Company Name

Name of Person Requesting Document(s)

Phone

Fax

Email Address

Are you are a registered bidder?
Choose Yes No

If Yes, enter vendor ID number and click submit at the bottom of the form. No further information is necessary. (If you do not know your Vendor ID number or have just registered please provide the requested information in all spaces below)

If No, complete all of the information requested below and submit a UT Bidder List Application.

Street Address

City

State

Zip/Postal Code

Federal ID

Is your company minority-owned?*
Choose Yes No

* If at least 51% of the business is owned by a member or members of the following groups: Asian-Pacific Americans, Asian-Indian Americans, Black Americans, Hispanic Americans or Native Americans as defined in F.A.C. 19.001(b).

If yes, indicate on what basis:
Choose Race Gender Religion Other

If other, explain:

Ethnic Background (as defined in T.C.A. 12-3-802(5))
Choose Asian-Indian American Asian-Pacific American Black American Hispanic American Native American

Has your firm been certified as a minority-owned business by the Tennessee Department of Economic and Community Development?
Choose Yes No

Small Business (as defined in Tennessee Code Annotated 12-3-802(3))
Choose Yes No

Note: If you are not a registered bidder for UTC you must submit a Bidders Application Form in addition to this Online Intent to Bid Form.