• SUPPLIER DIVERSITY SELF-CERTIFICATION FORM

    SUPPLIER DIVERSITY SELF-CERTIFICATION FORM

  • The following information is being requested on behalf of Diversified Maintenance. In support of our Supplier Diversity Program, Diversified Maintenance is required to maintain certification of Business Size and Ownership from all of their suppliers. Your participation in reporting this information is important for ensuring successful relationships among all members of the business community. Their entire supplier base, regardless of size or ownership, is encouraged to actively support this Supplier Diversity initiative. They will do this through programs designed to increase the inclusion of small and diverse businesses in Diversified Maintenance’s sourcing process. 

  • Definition: A small business is a business that is classified as “small” under the guidelines set forth by the Small Business Administration. Business size is dependent on the NAICS code, the number of employees, and the annual sales of a given company. Please refer to http://www.sba.gov/size for more details.

  • Certification as a Diverse Business

  • If applicable, indicate the agency from which your company has been certified as a diverse business or as a small business enterprise.

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  • The undersigned declares the foregoing statements are true and correct.

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  • IMPORTANT NOTICE - Under 15 U.S.C. 645(d), any person who misrepresents a firm’s status as a small business in order to obtain a subcontract that is to be included as part or all of a goal contained in a subcontracting plan required pursuant to Section 8(d) of the Small Business Act, shall (1) be punished by imposition of a fine, imprisonment, or both; (2) be subject to administrative remedies; and (3) be ineligible for participation in programs conducted under the authority of the Act.

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