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Read the
PVTA DBE Policy Statement
Company Name:
Required
Company Address:
Required
Address 2:
Company City:
Required
Company State:
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip code:
Required
Invalid format.
Country:
USA
Canada
Contact Name:
Contact Email:
Required
Invalid format.
Contact Phone:
Required
Contact FAX:
Product/Service Offered:
Required
Age of Firm: (years)
Required
Annual Gross Receipts:
Select one...
Less than $500,000
$500,001-$1,000,000
$1,000,001-$5,000,000
More than $5,000,000
Select a receipt range.
Registered DBE:
No
Yes
If DBE, select one:
Black Americans
, which includes persons having origins in any of the Black racial groups of Africa
Hispanic American
, which includes persons of Mexican, Portuguese, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race
Native Americans
, which includes persons who are American Indians, Eskimos, Aleuts, or Native Hawaiians
Asian-Pacific Americans
, which includes persons whose origins are from Japan, China, Taiwan, Korea, Vietnam, Laos, Cambodia, the Philippines, Samoa, Guam, the U.S. Trust Territories of the Pacific, and the Northern Marianas
Asian-Indian Americans
, which includes persons, whose origins are from India, Pakistan, and Bangladesh
Women
, regardless of race, ethnicity, or origin
Other
, individuals found to be disadvantaged by the Small Business Administration Pursuant to Section 8(a) of the Small Business Act