Vendor Information Form
GENERAL INFORMATION
:: * Required Fields ::
* Company Name:
Parent Company:
* Type of Entity:
If other:
* Federal ID Number:
(SSN if Sole Proprietorship)
* Owner's Name:
(First Name Last Name)
* Company Contact:
(First Name Last Name)
* Physical Address:
* City / State / Zip:
    
* Country:
   Mailing Address Same as Physical Address
* Mailing Address:
* City / State / Zip:
     
* Country:
* Telephone Number:
( ) - Ext.
* Fax Number:
( ) -
* E-mail Address:
Company Website (URL):
COMPANY DATA
 
List and describe products and/or services that your business offers:    
 

NAICS Codes:
PHA has created some Custom NAICS codes for certain industries. Both general and custom codes are selected using the "Select NAICS Codes" link to the right. See below links for details on custom codes:

Engineering - Contractors
Engineering - Consultants
Environmental

Click Here to Select NAICS Codes (Please turn OFF the popup blocker)

To remove items from the list above, highlight the category and hit Remove from List.
County:
 
If other:  (where business is located)
Are you a small business as defined by the Port of Houston Authority:

Yes No
If yes, please review the PHA SBDP's Policy and Procedures.

  Port of Houston Small Business Definition:
 
As defined in the SBDP’s Policy and Procedures, a “Small Business” is “a firm for which the gross revenues or number of employees averaged over the past three years, including any affiliates as defined by 13 C.F.R. § 121.103, does not exceed the size standards as defined pursuant to Section 3 of the Small Business Act and 13 C.F.R. § 121.201, and for which the net worth of each owner does not exceed $750,000, excluding principal residence and the value of the small business.” Pursuant to the SBDP’s Policy and Procedures, a small business has a “Significant Local Presence” if it is located “in one or more of the counties of Harris, Galveston, Fort Bend, Montgomery, Liberty, Waller, Chambers, or Brazoria, Texas, with one or more of its employees regularly based therein.
  
 

How to Become a Port Approved SBE:
 
1. Your company must be a small business as defined above.
2. Your company must be certified by either the City of Houston, Houston Minority Business Council (HMSDC), Metropolitan Transit Authority (METRO), and the Women’s Business Enterprise Alliance (WBEA); a copy of this certificate must be submitted to the Port of Houston Small Business Group.
3. Your company must complete and submit the PHA SBE Application form.

Please note: The Port of Houston Authority is not a small business certifying agency.
  

Is your business certified by one of the accepted certifying agencies below:
Yes No
If yes, by whom? City of Houston
 HMSDC WBEA
Metro  
 
 
Certificate Instructions: If yes, please fax (713-670-2498) or upload a copy of your certificate or letter of certification.  The uploaded certificate must be in a .jpg or .gif file format. Please be sure to fill in all pertinent information requested.
Certifying Agency (1)
Certification No.
Expiration Date / (MM/YYYY)
Upload Certificate
 
Certifying Agency (2)
Certification No.
Expiration Date / (MM/YYYY)
Upload Certificate
 
Certifying Agency (3)
Certification No.
Expiration Date / (MM/YYYY)
Upload Certificate
 

All vendors and contractors will adhere to the Port of Houston Authority's insurance requirements that are specified in the "Procurement Packages".
By choosing to submit this form, you certify that the information you have provided above is true and accurate.
  
 

Copyright 2007 Port of Houston Authority. All Rights Reserved.