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Type of Organization
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Telephone Number
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Fax Number
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Email
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Category
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Construction
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Type of Construction
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General Contractor
Electrical
HVAC/Mechanical
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Roofing
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Tile
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General Goods & Services
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Catering
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Type of Medical Supplies
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Other/Please Describe
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Description of Services/Products
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Have you previously done business with TGH?
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No
Do you have healthcare experience or experience working in a hospital environment?
*
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Company Owner Name
Owner Phone
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Owner Email
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Company Primary Contact
Name
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Official Capacity
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Telephone Number
*
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Fax Number
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Email
*
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Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner Ethnicity
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African American
Hispanic
Native American
Women
Pacific Islander
Asian
Caucasian/White(Non-Hispanic)
Is the company certified as a Minority/Women Business Enterprise (MBE/WBE)?
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Yes
No
MBE/WBE
Minority/Women Business Enterprise (MBE/WBE) Category
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African American
Hispanic
Native American
Women
Pacific Islander
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Certifying Agency
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-
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Additional Information
Years in Business
Number of Employees
Annual Gross Sales
Please let us know what prompted you to register with Tampa General Hospital
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Notified by Purchasing
Notified by MBE Office
Community or M/WBE Organization
Vendor Outreach Event
Referred by employee
Found on website
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