Intake Form for Potential DDi Suppliers

Please read the following notice carefully before you complete the Intake Form.

In accordance with Government regulations and prime contract requirements, we must verify certain information about our suppliers. To help you complete the Intake Form, refer to the definitions below or contact your buyer or DDi Inc. representative. Notice: Under 15 U.S.C. 645 (d), any person who misrepresents a firm's status as a small business concern in order to obtain a contract to be awarded under the preference programs established pursuant to sections 8 (a), 8 (d), 9, or 15 of the Small Business Act or any other provisions of Federal Law that specifically reference section 8 (d) for a definition of program eligibility, shall (1) be punished by imposition of a fine, imprisonment, or both; (2) be subject to administrative remedies, including suspension and debarment; and (3) be ineligible for participation in programs under the authority of the Act. You will not receive contracts from DDi if a profile is not returned complete. Submission of this form does not constitute approval of your firm as a supplier, nor obligate DDi to solicit requests for quotation. The data on this form will be used to evaluate the potential of your firm as a DDi supplier.

Definitions: The definitions required to complete this form are found in the Federal Acquisition Regulation. Please refer to the Federal Acquisition Regulation Part 19, 25 for a comprehensive definition. The definition for Service Disabled Veteran can be found in Public Law 106.50

If you are unsure of your business size, contact your local Small Business Administration (SBA) office.

Please complete the following Supplier Intake Form in order to be placed in the DDi list of potential suppliers. After you complete the form you will be notified should DDi have an interest in your products or services. Multiple submissions do not improve your visibility to DDi; however, you should complete a new Intake Form if your information changes after your submittal.

Primary Business Information		* Indicates a required field
* Business Name:		* Street Address:
* City:		* State:
* Postal Code:		* Point of Contact:
* Contact Phone Numer:		Contact Email:
* Organization Type:	Select One Sole Proprietorship Corp. Entity Corp. (tax-exempt) Partnership Foreign Company Other	* Federal Tax ID:
* NAICS 2002 Number:		* Years in Business:
* Number of Employees:		Owners Name:
For Corporations
* In which state were you Incorporated:
Small Business Information
* Business Size:	Small    Other	If Other:
* Minority Owned:	Yes    No
* Ethnicity:	Select One Asian Pacific American African American Hispanic American Native American Subcontinent Asian American Decline
* Woman Owned:	Yes    No
* American Vet Owned:	Yes    No
Disabled Vet Owned:*	Yes    No
* Small Disadvantaged  Business Certified:	Yes    No	Certified Date:
* National Minority  Supplier  Development Council:	Yes    No	Certified Date:
* Historically Underutilized  Business (HUB Zone):	Yes    No	Certified Date:
* Woman Business  Enterprise National  Council:	Yes    No	Certified Date:
Products & Services			Check as many as apply
Business Supplies:		Staffing Services:
Chemistry:		Finance:
Security:		Facilities Maintenance:
IT (Software):		IT (Hardware):
Training:		IT (Services):
Consulting:		Tools & Equip (General):
Materials:		Tools & Equip (Industry):
Janitorial:		Safety Supplies:
Uniform Supply:		Other:
Food Service:		If Other: