City of Albuquerque Local Business Survey

Please fill out the following questions to self-certify as a local, minority-owned, or woman-owned business with the City of Albuquerque.
*Required

* 1. Name of Company

* 2. Business Information

* 3. Total No. of Employees (full & part time)

* 4. Are you a current member of the Hispano Chamber of Commerce?

* 5. Are you registered with the City of Albuquerque to do business?

* 6. What is your City Business Registration Number? Ex BRC-2016-340790 or HB-2016-340790. If non applicable please enter NA.

* 7. Is your business local?

* 8. What percent of your business owners are minority?
E.g., if there is only one owner and that owner identifies as minority, please write 100. If 2 out of 3 of your owners identify as minority, please write 66. If your business is publicly traded, please report the % of your company stock held by owners from a minority group. Please enter as whole numbers with no decimals or percentage sign.

* 9. Is your business minority owned? Yes/No; If so please specify the race or ethnicity of minority owner(s): Please mark all that apply.

* 10. Is your business women owned? If so, what percent of your business owners are female?
E.g., if your business has one owner and she is female, please write 100. If 2 out of 3 of your business owners are female, please write 66. If your business is publicly traded, please report the % of your company stock held by women. Please enter as whole numbers with no decimals or percentage sign.

* 11. Are you a Veteran owned business?

* 12. Type of Business (choose primary commodity category or NIGP code) National Institute of Governmental Purchasing (NIGP)

* 13. Specific Business Type (restaurant, clothing store, gas station)

* 14. Month & Year Business Started? MM/DD/YYYY

* 15. Are you a home based business?

* 16. What is the legal entity of your business?

* 17. Please tell us your biggest barrier to doing business with the City of Albuquerque.

* 18. By clicking on the Certify box below, I certify that the information I provided in this survey is true, accurate, and complete, including the questions related to women-owned, minority-owned, and veteran-owned business.  Should any changes occur to my status as a women-owned, minority-owned, or veteran-owned business, I will notify the Hispano Chamber of Commerce immediately.  I also understand that any false statements in this survey may be grounds for removal of my business from this database permanently.

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