Subcontractor Registration Form
General Company Information
Company
*
Federal Identification Number
Dun & Bradstreet (DUNS) Number
ISNetworld # if Applicable
E-Verify Registered
(Check Box for Yes)
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Fax
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Website
Availability
Check this box if your resources are currently available
HE Disaster Restoration Experience?
Check this box if you have previously worked with us
List the HEDR project(s) you have worked.
Business Size & Classification (Check all that apply)
Disasters are devastating — but you can help. Follow the steps outlined below to register as a federal contractor, certify your small business, and begin the recovery process in your community.
Register With Sam
You will need to register your business with the federal government’s SAM, or System of Award Management, the primary database of vendors contracted with the federal government. This registration, referred to as “SELF-CERTIFYING” YOUR SMALL BUSINESS, is required by the Federal Acquisitions Regulations (FAR) of all prospective vendors before the award of a contract. By completing this certification, you market your business for further contract opportunities based on your size, location, and experience. Visit this link to register: https://sam.gov/content/entity-registration
Get Your NAICS Code
While registering for SAM, you may notice that you need a North American Industry Classification System (NAICS) code for administrative, contracting, and tax purposes. This code classifies the economic sector, industry, and country of your business. Visit this link for more information: https://www.sba.gov/contracting/getting-started-contractor/determine-your-naics-code
(Check all that apply)
Large Business (LB)
Small Disadvantaged Business (SDB)
8a Designation
Veteran-Owned Small Business (VOSB)
Small Business (SB)
HUBZone Small Business
Woman-Owned Small Business (WOSB)
Service-Disabled Veteran-Owned Small Business (SDVOSB)
Are you Registered with the System for Award Management?
Check this box if YES
CAGE Code
Other Small Business Certifications
Services Provided (Check All That Apply)
(Check all that apply)
Emergency Road Clearance
Debris Reduction
Permitted Solid Waste Facility
Project Staffing
Recycling
Debris Collection
Tree Trimming and Removal
Stumps
Marine Debris Removal
Site Management
Hauling
Snow Removal
Sand Screening
Recycling Material Type
Other Services
Equipment Owned (Do Not Include Any Subcontracted Equipment)
Enter the QUANTITY of each kind of equipment in the fields below
How many Self Loaders?
How many Self Loaders with Trailers?
How many Dump Trucks (<40 Cubic Yards)?
How many Dump Trucks (40-80 Cubic Yard capacity)?
How many Dump Trucks(>80 Cubic Yard capacity)?
How many Skid Loaders?
How many Front End Loaders?
How many Rubber Tire Excavators?
How many Tub/Horizontal Grinders?
How many Bucket Trucks (<50' boom)?
How many Bucket Trucks (>50' boom)?
How many Excavators?
How many Bull Dozers?
How many Walking Floors?
How many Dump Trailers?
How many Water Trucks?
Other Equipment
Comments
Disclaimer
Disclaimer: By providing the information requested to Harden Enterprise Services LLC, you promise that all information you provide will be accurate, current and truthful to the best of your knowledge. You further agree and acknowledge that Harden Enterprise Services LLC will be relying on the information, that Harden Enterprise Services LLC has no obligation to retain you as a subcontractor and that Harden Enterprise Services LLC reserves the sole and exclusive right to retain any subcontractor or no subcontractors at all for a particular project. TO KNOWINGLY INPUT FALSE INFORMATION, INCLUDING, BUT NOT LIMITED TO NAME, PHONE NUMBER, ADDRESS AND COMPANY DATA IS A VERY SERIOUS AND FRAUDULENT MATTER THAT COULD RESULT IN SIGNIFICANT COSTS AND DAMAGES, AS WELL AS LOSS OF TIME, EFFORT AND EXPENSE, AND ACCORDINGLY, IF YOU PROVIDE FALSE INFORMATION YOU WILL FULLY INDEMNIFY ASHBRITT AND BE LIABLE FOR ACTUAL DAMAGES, DIRECT, PUNITIVE AND CONSEQUENTIAL, AND ANY REGULATORY OR JUDICIAL FINES OR PENALTIES THAT MAY ARISE FROM SUCH MISLEADING, HARMFUL AND FRAUDULENT INFORMATION, PLUS REASONABLE LEGAL FEES, COST AND EXPENSES RELATING THERETO.
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