Form GSA Form 3685 GSA Form 3685 Disaster and Emergency Operations Vendor Profile

OMB Control Number: 3090-0163
Expiration Date: 06-30-2008

GSA Office of Small Business Utilization
Disaster and Emergency Operations Vendor Profile (GSA Form 3685)

Denotes required field.
Company Name:
Contact Name:

Address:

City:
State:

Select State/Territory

Zip Code:

Office Phone Number:
Cell Phone Number:
E-mail address:
Company Website:

http://

1. NAICS Code:

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2. NAICS Code:

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3. NAICS Code:

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4. NAICS Code:

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5. NAICS Code:

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6. NAICS Code:

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7. NAICS Code:

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8. NAICS Code:

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9. NAICS Code:

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DUNS Number:

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Can accept Government Purchase Card
payments:

Yes

No

Registered in Central Contractor
Registration (CCR):

Yes

No

Types of products or services offered:

Type

A.

Select desired Type

B.

Select desired Type

C.

Select desired Type

D.

Select desired Type

E.

Select desired Type

F.

Select desired Type

G.

Select desired Type

H.

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Business Class & Certifications
(select all that apply)

Complete as many as necessary.
You must complete at least one before you can continue.

Description

Quantity on hand/ can
deliver today

LARGE BUSINESS
SMALL BUSINESS
8(a) CERTIFIED
SMALL DISADVANTAGED BUS.
HUBZone SB CERTIFIED
WOMAN-OWNED
VETERAN-OWNED
NATIVE AMERICAN-OWNED
SERVICE-DISABLED VETERAN-OWNED

Remarks:

NOTE: This form is for informational purposes and does not imply any contract or promise of business.
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