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MAR -13 -1997 14 :16 <br />* <br />DIVISION OF PUIR'CNASING 3038947445 .P.03/03 <br />This form is used by the Division ofPurchasing for informational purposes only. This form <br />cannot and will not be used in the evaluation of your bid or proposal. <br />RFP/BID NUMBER:. -- 8` <br />Small business participation: the State of Colorado is tracking the extent of participation by small <br />businesses. The below information must be completed and submitted with your bid or proposaL <br />1. Is your firm a small business *? Yes — No <br />2. If yours is not a small business, please indicate, to the best of your ability, the total dollar <br />value of products and/or services that will be provided by small business subcontractors: <br />FEIN/Social Security #: R – 130 I I `1 <br />(Federal Employer's Identification Number) <br />b\Re • - N <br />Signature Company Name <br />MA JE M, IRtCK 16g5 /7 Rb. <br />Printed Name Address <br />q70- 145a -gboq 6r=�X) 97x9 °fRSJ' -ii;31 ( l . /7„ 19 <br />Phone and FAX Numbers Date <br />Title City/State/Zip Code <br />— for commodities and services def ned as a business with a total of twenty -five or <br />fewer full-time equivalent employees and with its principal office located in the State of <br />Colorado. <br />— for construction, defined as a general contractor with annual gross income under $16 <br />million, a subcontractor with annual gross income under $7 million and <br />architectural/engineering firms with annual gross income under $2.5 million. <br />