Florida Emergency Supplier Network
Company
General
Registration #
Primary Business Name
*
Primary Business Address
*
City
*
State
*
Zip
*
Primary Business Phone
*
(10-digit phone number)
Extension
Primary Business E-mail
*
Website URL
Is your company a registered vendor in the
MyFloridaMarketPlace
e-Procurement System?
*
Yes
No
Is your company registered with the
Florida Division of Corporations
?
*
Yes
No
Is your company a State of Florida
Certified Minority Business Enterprise
?
*
Yes
No
Is your Company registered with the
Florida Department of Business and Professional Regulations (DBPR)
?
*
Yes
No
FEIN:
*
FEIN
Company Profile
How long has your present company been in your current business (in years)?
*
< 1
1 - 5
6 - 10
> 10
How many employees does your company have?
*
1 - 10
11 - 25
26 - 100
101 - 500
> 500
What are your approximate annual gross sales?
*
$1 - 100,000
$100,101 - 500,000
$500,001 - 1,000,000
> $1,000,000
Services Only
Value of product inventory:
*
$1 - 100,000
$100,101 - 500,000
$500,001 - 1,000,000
> $1,000,000
Services Only
How many business locations does your company maintain in the State of Florida?
*
0
1
2 - 5
5 - 10
> 10
List locations here that are able to serve Florida during an emergency (include any non-Florida locations):
Emergency Mobilization Capabilities and Commitments
In emergency situations, are items of equipment for (check all that apply):
Short term rental
Leasing
Outright Purchase
Comments, if any:
Will your company offer discounts to Governmental Agencies after an Emergency Declaration is issued?
*
Yes
No
If yes, discount from retail prices (MSRP) to be offered:
Briefly describe your company's escalation procedures for problem resolution during emergency operations:
*
Briefly describe your company's plans for continuity of operations (employee and supply chain support) during emergency operations:
*
Any additional comments you may wish to offer regarding the support your company can provide to the Florida Emergency Network, such as staff availability, equipment availability, relevant expertise and/or the value of your product inventory level:
Company
General
Contacts
Profile
Mobilization
Counties
Products & Services
Application
Printable View
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