Oneida Nation

Vendor Business Application - Indian Preference


Business Type
Business Name
Business Address

Business Owners Details

Business Contact Details

Main Contact:  
Contact Phone: Business Phone:
Fax: Website/URL:
Contact Email: Business Email: 

Business Identification

Business Federal ID #:  
 
Detail the services that your company provides:
 

Business Metrics

Date Business Established:
Principle Business Contact:  
% Native American Owned:
Full-Time Employees
Native American: Minority: Non-Minority:
Part Time Employees
Native American: Minority: Non-Minority:
Is your firm certified by one or more of the following?:
Upload Copies of Certifications:

Business Locations

Are there multiple locations for this business:
List all location addresses currently used:
Has this business been known by any other name:
List all prior names used by your company:

Business Operations

List individuals who are responsible for the following obligations:
Does this firm have business relationships that involve shared space, equipment, financing, same owners, or shared employee agreements?:
List any current business relationships with different companies that have one or more of the same owners of this business:
Does this firm have any working relationships/agreements (written or oral) with any other business.:
Describe these arrangements/agreements:

Required Attachments

Upload - Certificate of Insurance: Upload - Credit Reference:
Upload - Key Personnel Resumes: Upload - Company Structure Update of Principal Changes:
Upload - References/Portfolio: Upload - Proof of Wisconsin LLC:
Upload - Partnership Agreement: Upload - State Registration:
Upload - Corporate By-laws: Upload - Stock Certificates:
Upload - Articles of Incorporation: Upload - Meeting/Board Action Minutes:
   

 

By signing you agree that the undersigned, swear that the foregoing statements are true and correct and include all material information necessary to identify and explain the operation of the business, as well as ownership status thereof.
Further, the undersigned agrees to provide complete and accurate information regarding actual
work performed on any project, the payment thereof, and any proposed changes of the foregoing arrangements and to permit the examination of records, files of the firm or affiliate of the said firm in connection with certification procedures. Any misrepresentation will be grounds for decertification. "By completing this application I hereby affirm, under penalty of perjury, that the statements I have made herein are true and correct. I understand that if I am granted certification by the Indian Preference Department, my certification may be revoked at any time if it is discovered that any statements I have made on this application are false. I further, understand that I may be subject to other sanctions if I commit fraud or misrepresentation in completing this application."

 

Applicant Full Name:
Applicant Email:

Leave this empty:

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Signature Certificate
Document name: Vendor Business Application - Indian Preference
lock iconUnique Document ID: 53ac8af81f5302607ca86983e7a9af1390311c4e
Timestamp Audit
May 12, 2021 8:18 am CDTVendor Business Application - Indian Preference Uploaded by Oneida Nation - webmaster@oneida-nsn.gov IP 74.62.93.29
May 13, 2021 10:23 am CDTOneida Indian Preference - OneidaIndianPreference@oneidanation.org added by Oneida Nation - webmaster@oneida-nsn.gov as a CC'd Recipient Ip: 74.62.93.28
May 13, 2021 11:04 am CDTOneida Indian Preference - OneidaIndianPreference@oneidanation.org added by Oneida Nation - webmaster@oneida-nsn.gov as a CC'd Recipient Ip: 74.62.93.28
May 5, 2022 2:15 pm CDTOneida Indian Preference - OneidaIndianPreference@oneidanation.org added by Oneida Nation - webmaster@oneida-nsn.gov as a CC'd Recipient Ip: 74.62.93.29
May 5, 2022 2:15 pm CDTWeb Master - webmaster@oneidanation.org added by Oneida Nation - webmaster@oneida-nsn.gov as a CC'd Recipient Ip: 74.62.93.29
May 5, 2022 2:23 pm CDTOneida Indian Preference - OneidaIndianPreference@oneidanation.org added by Oneida Nation - webmaster@oneida-nsn.gov as a CC'd Recipient Ip: 74.62.93.29
May 5, 2022 2:23 pm CDTWeb Master - webmaster@oneidanation.org added by Oneida Nation - webmaster@oneida-nsn.gov as a CC'd Recipient Ip: 74.62.93.29