Local Supplier Intake Form
Thank you for your interest in The Coalition's DC Community Anchor Partnership (DCAP). As a collaborative of local “anchor institutions" (hospitals, universities, utilities, and other large companies), we work to harness local purchasing power to help grow DC-based small- and medium-sized businesses. We hope you will join our local supplier network to get notified about contracting opportunities, connect with institutions and large buyers, and be visible to partners looking for vendors. For more information about DCAP, visit www.thecoalitiondc.org/DCAP
Name
*
First Name
Last Name
Job Title
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Legal Business Name
*
Year Founded
*
Website URL
*
Primary Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
DC Ward (if applicable)
*
Please Select
Ward 1
Ward 2
Ward 3
Ward 4
Ward 5
Ward 6
Ward 7
Ward 8
N/A
What primary industry category most accurately captures your business?
*
Architecture & Design
Engineering
Catering & Food Services
Cleaning & Janitorial
Communications & Marketing
Construction
Property Maintenance & Management
Product-Based Offerings (Includes supplies and equipment)
Professional Services
Other Services
Which Architecture & Design subcategories most accurately capture your business?
*
Architectural Engineering
Design/Build
Historic Preservation
Interior/Exterior Design Renovation
Tenant Build-Outs/Improvements
Other
Which Engineering subcategories most accurately capture your business?
*
Civil Engineering
MEP Engineering
Structural Engineering
Environmental Engineering
Other
Which Catering & Food Services subcategories most accurately capture your business?
*
Full-Service Catering - Large (250+ guests)
Full-Service Catering - Small (under 250 guests)
Boxed Meals/Individually Packaged Meals
Automated Delivery Platform
Other
Which Cleaning & Janitorial subcategories most accurately capture your business?
*
Janitorial/Custodial
Glass & Window Cleaning
COVID-19 Cleaning
Other
Which Property Maintenance & Management subcategories most accurately capture your business?
*
Property Management Services
Grounds Maintenance/Landscaping/Snow Removal
Waste Management/Recycling/Trash Removal/Hauling
Handyman and Handywoman Services
Pest Control
Controls/Building Automation Systems
Fire Protection Systems
Inspections
Other
Which Communications & Marketing subcategories most accurately capture your business?
*
Advertising
Marketing
Branding
Web Design & Development/Video Animation
Other
Which Construction subcategories most accurately capture your business?
*
General Contracting
Drywall
Concrete
Masonry
Finishes
Equipment
Plumbing
Earthwork
Painting
HVAC
Carpentry
Flooring
Roofing
Electrical
Fire Suppression
Project & Construction Management
Commissioning
Third Party Inspections
Owner's Representative Services
Other
Which Trades subcategories most accurately capture your business?
*
HVAC
Plumbing
Electrical
Painting
Drywall
Flooring/Carpentry
Other
Which Product-based offerings subcategories most accurately capture your business?
*
Office Supplies (including furniture)
Furniture Distributor
Promotional Items/Stationery
Signage
Other
Which Professional Services subcategories most accurately capture your business?
*
Financial Services (i.e. Accounting, Auditing, Tax, Payroll, Operational Audits)
Legal
Temporary Staffing/Recruiting
Language Translation
Travel Services
IT Services
Other
Which Other Services subcategories most accurately capture your business?
*
Ground Transportation
Event Planning
Audiovisual Design & Build
Photography
Furniture Movers/Management Services
Travel Services
Other
Which of the following certifications does your business currently hold and maintain in active/good standing?
Certified Business Enterprise (CBE) - Washington, DC
Minority-Owned Business Enterprise (MBE)
Women-Owned Business Enterprise (WBE)
Disadvantaged Business Enterprise (DBE)
Small Business Enterprise (SBE)
Veteran-Owned Small Business (VOSB)
Service-Disabled Veteran-Owned Small Business (SDVOSB)
LGBTQ-Owned Business
HUBZone Certification
8(a) Business Development Program
None at this time
Which of the following certifications does your business currently hold and maintain in active/good standing?
*
Certified Business Enterprise (CBE) - Washington, DC
Minority-Owned Business Enterprise (MBE)
Women-Owned Business Enterprise (WBE)
Disadvantaged Business Enterprise (DBE)
Small Business Enterprise (SBE)
Local Business Enterprise (LBE)
Veteran-Owned Small Business (VOSB)
Service-Disabled Veteran-Owned Small Business (SDVOSB)
LGBTQ-Owned Business
HUBZone Certification
Small Local Business Enterprise (SLBE) - Metropolitan Washington Airport Authority
8(a) Business Development Program
Green/Sustainability Certification (please specify)
None at this time
With which racial/ethnic community does the business owner(s) identify?
*
American Indian or Alaska Native
Asian
Black or African-American
Hispanic, Latino, or Spanish
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
Other
Has your business previously performed work as a subcontractor or subconsultant on a public or private sector contract/project?
*
Yes - Public sector contracts
Yes - Private sector contracts
Yes - Both public and private sector contracts
No
Unsure
If yes, please provide the following (optional):
Does your business currently maintain business insurance and/or bonding?
*
Yes
No
Unsure
Is at least 51% of your business woman-owned?
*
Yes
No
Is your business a Certified Business Enterprise (CBE)?
*
Yes
No
How many full-time employees, excluding yourself, does your business employ?
*
How many part-time employees does your business employ?
*
How many of your total employees are residents of the District of Columbia? An estimate is acceptable.
*
Have you done business with any hospitals in the DMV region? If yes, check the appropriate box(es).
*
Adventist HealthCare
BridgePoint Hospital
Children's National Health System
Johns Hopkins Health System (e.g. Sibley Memorial)
Kaiser Permanente of the Mid-Atlantic States
MedStar Health
Universal Health Services (e.g. Cedar Hill & GW Hospital)
Psychiatric Institute of Washington
Providence Health Village (Ascension)
Whitman-Walker Health
N/A
Other
Have you done business with any universities in the District of Columbia? If yes, check the appropriate box(es).
*
American University
Catholic University
Howard University
Gallaudet University
Georgetown University
George Washington University
Trinity Washington University
University of the District of Columbia
N/A
Other
Have you done business with any utility companies in the District of Columbia? If yes, check the appropriate box(es)
*
DC Water
Pepco
Washington Gas
N/A
Other
Are you a client or past participant with any of our referral partners? If yes, check the appropriate box(es).
*
Clark Construction Strategic Partner Program
DSLBD / APEX Accelerator
Emerald Cities Collaborative E-Contractor Academy
IMT's Building Innovation Hub
Latino Economic Development Center
Metropolitan Washington Airports Authority Small Business University
Washington Area Community Investment Fund
N/A
Is there anything else you would like to share with us?
Please upload your latest capability statement.
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