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BDAG Application
Applications are only for businesses located in the state of Washington.
1.
Contact Information
Name of Applicant
Your title and role in the business
Name of the business
Business Street Address
City
County in Washington
What type of work does your business do?
Email Address
Phone Number
2.
Are you an OMWBE (Washington State Office of Minority & Women's Business Enterprise) or DVA (Washington State Department of Veterans) certified firm?
OMWBE
DVA
Other (please indicate here)
3.
If you do not hold an certification, is your firm owned (at least 51%) by minority, women, women-minority, or veteran?
Minority
Women
Women-Minority
Veteran
Other
4.
Are you willing to obtain the certification by OMWBE or DVA?
Yes
No
5.
Is your firm registered in WEBS as a Washington state small business? If not, you must register your business on
WEBS
Yes
No
6.
Are you a non-profit for the blind?
Yes
No
7.
Are you with a non-profit that helps small business?
Yes
No
8.
If you hold any statewide contract(s) currently, please provide the contract number:
9.
Do you have any experience bidding on government contracts?
State contracts
Any other government contracts
Other (please specify)
10.
Are you able to make a commitment to serve for a one year or three year term? Please select one.
one-year term
three-year term
11.
Are you connected in your business community? If so, please describe the business community you are affiliated with.
12.
Has any firm you've owned, including the current business(es) ever been debarred, suspended, or had labor or ethics violations?
Yes
No
