Vendor Information Form Please complete the following form to be considered for Port of South Louisiana projects. *Required fields *STATEAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming *IS YOUR BUSINESS REGISTERED WITH SAMS.GOV? YesNo IS YOUR COMPANY A CERTIFIED SMALL BUSINESS (select all that apply)? DBEHudson InitiativeMBESBEService Disabled VeteranWBE/WOSBOther CAN YOUR COMPANY PROVIDE THE FOLLOWING (select all that apply): W9Copies of Certifications Δ