Sands New York |

Company Information
Legal Company Name*
Company Representative
First Name*
Last Name*
Title/Position*
Office Phone Number*
Mobile Number*
Email Address*
Business Address
Street Address*
Address Line 2
City*
State / Province*
ZIP / Postal Code*
State of Incorporation*
Office Headquarters
Office Headquarters: City*
Office Headquarters: State / Province*
Years In Business*
Number of Employees*
Annual Revenue (USD)
Annual Revenue 2023*
Annual Revenue 2022*
Annual Revenue 2021*
Core Product(s) and/or Service(s)*
NAICS OR NIGP Code*
Are you a diverse supplier?*

YesNo
If you are currently NOT a certified Diverse Supplier, are you seeking certification assistance?*

YesNo
Diverse Classification:*

Minority-Owned Business Enterprise (MBE)Women-Owned Business Enterprise (WBE)Veteran-Owned Business (VET)Disadvantaged Business Enterprise (DBE)Other (please specify):
Other Diverse Classification
Certifying Agency:*

NY StateNY CityMTAPort AuthorityNassau CountySuffolk CountyNMSDCWBENCOther (please specify):
Other Certifying Agency
Certification Expiration Date*
Major Customers
1) Company Name*
1) Location*
2) Company Name*
2) Location*
3) Company Name*
3) Location*
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