Government Communications Systems Division (GCSD)

PROSPECTIVE SUPPLIER PROFILE

The purpose of this form is to provide the Harris Government Communications Systems Small Business Office basic information about your business. It does not put your firm on a bidder’s list, but it will assist you in promoting your firm within GCSD.

Please answer all questions or enter NA (Not Applicable).

1.Company Name
3. Mailing Address
5. E-mail Address / 2.Subsidiary or Affiliate
4.Facility Address
6.Internet Address
7.Telephone Number / 8.Fax Number / 9.NAICS Code
10.Business TypeManufacturingDistributorServicesOther
Capabilities: List products, services, and special capabilities.
11.Net Worth
Current Annual Sales /
Backlog of Sales / 12.Floor Space
Manufacturing /
Warehouse
13. Standard Business Classifications Per FAR 52.219-1:
Large BusinessSmall Business
Small Business Classification
Small DisadvantagedWomen-OwnedHUBZone
Veteran-OwnedService-Disabled Veteran-Owned
If Small Disadvantaged Business (Check Appropriate Blocks)
SBA Certified8A
Native American (Includes American Indians, Eskimos, Aleuts, or Native Hawaiians)
Historically Black College-University/Minority Institution (HBCU/MI)
  1. NOTICE: Misrepresentations of business classification for the purpose of securing a contract or subcontract shall
be punished by imposition of a fine, imprisonment, or both. Reference FAR 52-219-1(d)2.
This information is certified to be true to the best of my knowledge.
SignatureTitleDate

H-2057 (Rev. 08/01)

STANDARD BUSINESS CLASSIFICATION DEFINITIONS

(PER FAR 52.219-1, 19.001)

SMALL BUSINESS CONCERN:

A concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts and meets the criteria of 13 CFR Port 121. Manufacturing and distributing firms: total employees do not exceed 500, 750, or 1,000 as defined in FAR 19.102 and 13 CFR 121.201.

(NOTE: If firm total employment is between 500 and1,000, contact Small Business Administration for assistance for determining proper NAICS code size standard.)

SMALL DISADVANTAGED BUSINESS CONCERN:

A firm which meets the above criteria as a Small Business, and which is at least 51 percent owned by one or more socially or economically disadvantaged individuals; and whose management and daily business operations are controlled by one or more of such individuals; as defined in 13 CFR 124.1002

Socially and economically disadvantaged individuals include:

•Black Americans, Hispanic American, Native American (American Indians, Eskimos, Aleuts, or Native Hawaiians), Asian-Pacific American (persons with origins from Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Japan, China, Taiwan, Laos, Cambodia (Kampuchea), Vietnam, Korea, The Philippines, U.S. Trust Territory of the Pacific Islands (Republic of Palau), Republic of the Marshall Islands, Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, Guam, Samoa, Macao, Hong Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru), Subcontinent Asian (Asian-Indian) American (persons with origins from India, Pakistan, Bangladesh,
Sri Lanka, Bhutan, The Maldives Islands, or Nepal).

•Historically Black Colleges-Universities and Minority Institutions (HBCU/MIs) are classified as Small Disadvantaged concerns.

WOMEN-OWNED SMALL BUSINESS CONCERN:

A firm which meets the above criteria as a Small Business and which is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

HUBZONE SMALL BUSINESS CONCERN:

A small business concern that appears on the List of Qualified HUBZone Small Business Concerns maintained by the SBA.

VETERAN-OWNED SMALL BUSINESS CONCERN:

The term "veteran-owned small business concern" means a small business concern:

  • Not less than 51 percent of which is owned by one or more veterans or, in the case of any publicly owned business, not less than
    51 percent of the stock of which is owned by one or more veterans; and
  • The management and daily business operations of which are controlled by one or more veterans

VETERAN —The term "veteran" has the meaning defined in 38 U.S.C. 101 (2).

SERVICE-DISABLED, VETERAN-OWNED SMALL BUSINESS CONCERN:

The term "service-disabled small business concern owned" means a small business concern:

  • Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case any publicly owned business,
    not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and
  • The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of
    a veteran with permanent and severe disability, the spouse or permanent caregiver of such a veteran.

SERVICE-DISABLED VETERAN —The term "service-disabled veteran" means a veteran with a disability that is service connected
(as defined in section 101 (16) of title 38, United States Code).

NAICS CODE —North American Industry Classification System code. The Small Business Administration’s small business size standard
for all Federal Government programs. For more information, see:

Return to:
Harris Corporation
Government Communications Systems Division
P.O. Box 37
Attn: Small Business Office
MS: 8/9532
Melbourne, FL 32902-0037

H-2057 (Rev. 08/01)