The purpose of this form is to provide Rothers Technology with basic information about your business. It does not put your firm on a bidder’s list, but it will assist you in promoting your firm.

Answer all questions or enter NA (Not Applicable).

 

NOTICE: Misrepresentations of business classification for the purpose of securing a contract or subcontract shall be punished to the extent allowed by local laws and jurisdiction to include imposition of a fine, imprisonment, or both.

This information is certified to be true to the best of my knowledge.