IMS Small Business Partner Program Registration Form

Small Business Partner Program Registration

Please register your company with IMS for consideration on future projects. We look forward to working with you.
Step 1: General Information
Your Company's name
Company Website
Your Name

First Name Last Name
Your Title
Your Primary Email
example@example.com
Your Company EIN

Step 2: Company Information
Headquartered in the US:

Yes No

Primary Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Secondary Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

NAICS Code (primary):
NAICS Code (secondary):
CAGE Code:
Number of Employees:

Step 3: Contact Details
Contact

First Name Last Name
Title
Email
example@example.com

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
Fax Number

Area Code Fax Number

Step 5: Products & Services
Products & Services
Certifications and Industry Rankings
Series:
Are you currently debarred from working on Federal, State, or Local Contracts?

Yes No
Are you bondable?

Yes No
Do you carry workers compensation?

Yes No
Have you ever filed for bankruptcy?

Yes No

Step 6: Market Overview
History with IMS:
IMS Point of Contact:
Market Focus Description:
Agency with Mentor-Protégé Agreement:
Point of Contact:
Reason for Pursuing Relationship with IMS:
Competitors (Top 3):
Competitor 1
Competitor 2
Competitor 3
Clients:
Accept Government Credit Cards?:

Yes No
Existing/Past Business with Government Agency or Commercial Entity:
Agency
Contract Name
Contract #
Contract Value
Start Date
End Date
Indentify GWAC/GSA Schedule/Vehicle
References Include

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