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Pre-Application for Douglas County Small Business Program to support Data Center Development
*
1.
Business Contact Information
(Required.)
Legal Company Name
DBA Name (if applicable)
Physical Business Address (including City, State, Zip)
Mailing Address
Business Phone Number
Primary Contact Person Name
Primary Contact Person Title
Primary Contact Person Email
Primary Contact Person Phone #
Second Point of Contact Person Name
Second Point of Contact Person Title
Second Point of Contact Person Email
Second Point of Contact Person Phone #
2.
Please upload the business Secretary of State Filing
Choose File
No file chosen
3.
Please upload 2025 Business License
Choose File
No file chosen
*
4.
Please select your primary NAICS code from the dropdown menu.
(Required.)
23621
23622
2371
23711
23712
23713
2373
23731
2379
2381
23811
23812
23813
23814
23815
23816
23817
23819
23821
23822
23829
23831
23832
23833
23834
23835
23839
23891
23899
Other (please specify)
5.
Please select an additional NAICS code from the dropdown menu.
23621
23622
2371
23711
23712
23713
2373
23731
2379
2381
23811
23812
23813
23814
23815
23816
23817
23819
23821
23822
23829
23831
23832
23833
23834
23835
23839
23891
23899
Other (please specify)
6.
Please select an additional NAICS code from the dropdown menu.
23621
23622
2371
23711
23712
23713
2373
23731
2379
2381
23811
23812
23813
23814
23815
23816
23817
23819
23821
23822
23829
23831
23832
23833
23834
23835
23839
23891
23899
Other (please specify)
7.
Please select an additional NAICS code from the dropdown menu.
23621
23622
2371
23711
23712
23713
2373
23731
2379
2381
23811
23812
23813
23814
23815
23816
23817
23819
23821
23822
23829
23831
23832
23833
23834
23835
23839
23891
23899
Other (please specify)
8.
Please select an additional NAICS code from the dropdown menu.
23621
23622
2371
23711
23712
23713
2373
23731
2379
2381
23811
23812
23813
23814
23815
23816
23817
23819
23821
23822
23829
23831
23832
23833
23834
23835
23839
23891
23899
Other (please specify)
9.
Please upload you CV/Resume of Previous Contracts/Work Experience
Choose File
No file chosen
10.
Please upload your capabilities statement.
Choose File
No file chosen
11.
Please list any certifications or designations held by the company.
12.
Please upload a copy of your Commercial General Liability Insurance.
Choose File
No file chosen
*
13.
What is your three-year average revenue?
(Required.)
Under $500,000
$500,000 - $1,000,000
$1,000,000-$5,000,000
More than $5,000,000
14.
Please upload a recent P&L statement
Choose File
No file chosen
15.
Do you need funding?
Yes
No
16.
What year was the company founded?
17.
Number of FTE employees.
18.
Number of 1099 contractors.
*
19.
Disclaimer Statement: I understand that completion of this pre-application to participate in a Small Business Initiative and acceptance into the program does not guarantee any contracts or direct bid opportunities.
(Required.)
Agree
Disagree
*
20.
Disclaimer Statement: I understand that I may be asked to sign an NDA as a requirement for participation in the Small Business Program and failure to comply will automatically result in my removal from consideration.
(Required.)
Agree
Disagree
*
21.
Disclaimer Statement: I understand that as part of the Small Business program, I may be asked to partner or collaborate with other businesses, including opportunities for sub-contracting and partner bids to expand business capacity.
(Required.)
Agree
Disagree