Small Business Supplier Information Form for KC-45 Tanker Program
* Indicates required field.
Indicate whether you are a new or current Northrop Grumman Integrated Systems supplier:
Name of Northrop Grumman Buyer or referring individual:
Enter remittance address below.
Note if this is a change in address, a letter is required.
Enter correspondence address below.
Identify sales contact for correspondence address.
Specify company details below.
Type of business:*
Name of Principle Owner:*
Year of establishment:*
Number of employees:*
Amount of last year's sales:
Major Product lines:*
(You may include your company's website address along with product information).
The undernamed certifies that the above named company maintains a business classification as indicated below and that such classification is in accordance with all regulatory requirements related thereto. Further, it is understood and agreed that misrepresentation of the business classification is subject to penalties as prescribed in FAR 52.219.1.
Name of Certifying Official:*
Specify business classification.
If small is checked, check all of the following small business
Certified Small Disadvantaged Business (please forward SBA certification letter)
Small Disadvantaged Business (no SBA certification)
HUB-zone Small Business (please forward SBA certification letter)
Woman-owned Small Business
Veteran-owned Small Business
Service Disabled Veteran-owned Small Business
HBCU/MI (Historically Black Colleges, Universities/Minority Institutions)
Javitz Wagner O-Day Category
Specify ethnicity of principle owners.*
Subcontinent Asian American
Please remember to include any SBA certifications with your data submittal. If required, FAX to 310-335-4251.