Business to Business (B2B) Transactions

Company Name:

Your First Name:

Your Last Name:

Your Title:

Mailing Address:

City:

State:

Zip:

Phone Number:

Fax Number:

E-mail Address:

What minority business enterprises (MBEs) are you doing business with?

What products and/or services are currently being exchanged?

Monetary amount involved with these business transactions (contract value):

I NEED the following goods and/or services (if not applicable, type N/A):