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Cintas Supplier Diversity Data Sheet
* denotes a required field
Company*
Address/PO Box*
City*
State*
ZIP/Postal Code*
Contact Name *
Title*
Phone Number*
Fax Number*
E-mail Address*
Company Information
Year Established*
Corporate Structure *
Annual Sales *
Sales Last Year *
Sales Previous Year *
Number of Employees *
Certification
My company is certified by the following organizations (Check all that apply):*
WBENC
NMSDC (please state the name of certifying affiliate)
Municipality (please specify)
Other (please specify)
A copy of your certification must be faxed to 513.701.1955.
Our company is a member of the following Minority
Supplier Development Council(s)*:
Describe the composition of the company's owner(s). (Provide percentages)*
African American
%
Hispanic
%
Native American
%
Asian Pacific
%
Asian Indian
%
Women
%
Other
%
%
References*
Company Name/Contact/Phone Number
Description of Products/Services*
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Company History
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