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Please complete the form below to enroll in our Supplier Diversity Program.  The Supplier Profile allows TNMP to maintain vital records and statistics on companies with whom we conduct business.  Complete the form in its entirety.  Note that TNNP will need documentation from your company verifying that your organization has met  certification requirements by either the federal government, the state or a certifying agency or board.

Direct all questions to Kumiko Styes at (505) 241-2298.
Company Information
Company Name*
 Company Web Address

Owner Name
Title

Mailing Address
City
 

State*
Zip*


County
Contact Information

Contact Person*
Title

Area Code & Phone*


Fax
Email*
Company Data
Type of Organization:     Proprietorship   Partnership   Corporation
Is your business one of the following?

HUBZone Small Business
Veteran Owned Small Business 
Service Disabled Veteran Owned Small Business
None of the above

Products/Service Description

North American Industry Classification System (NAICS) 2-6 digits
Do you qualify as a small business (as stated in Section 3 of the Small Business Act 15 U.S. C 632)?

Yes  No

 

If you are a Small Disadvantaged Business, are you certified by the Small Business Administration?

Yes   No   If Yes, when?


Do you accept MasterCard/Visa?   Yes   No

In order to qualify as a M/MWBE, the company must be 51% owned, operated and controlled by a minority (s) or woman/women.  If your company qualifies, please check the appropriate classification.
African American Male
African American Female
Asian Indian American Male
Asian Indian American Female
Asian Pacific American Male
Asian Pacific American Female		 Hispanic Male
Hispanic Female
Native American Male
Native American Female
White Female
 

If you have been certified by a Minority Business Enterprise or Woman Business Enterprise certifying agency, please complete the following:

Certified:   Yes   No
 

Agency's Name

  

Date
Agency's Name
 Date
Information submitted by*
  		 Date

Additional Comments:
 

Any person or entity who knowingly and willfully makes a false, fictitious or fraudulent statement or misrepresentation pertaining to its status as a Minority/Women Business Enterprise shall be subject to suspension, exclusion, or ineligibility for participation in any program, activity, or contract function with Texas-New Mexico Power Company.

  

 

 
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