Pursuant to 35 ILCS 200/18-50.2, Contractors and all subcontractors are required to complete and submit a Vendor DBE certification, regardless of DBE status. Contractor shall complete and require all its subcontractors to complete the DBE certification for this project at https://www.bensenville.il.us/1280/Vendor-Self-Service-VSS
The information necessary for the Contractor and all subcontractors to complete the certification includes the following: DBE Classification (minority-owned, women-owned, persons with disabilities-owned, veteran-owned, or none); if DBE, whether the company holds a certificate or self-certifies; if self-certifying, whether the company qualifies as a small business under the U.S. Small Business Administration standards; the company’s name, address, city, state and zip code; company’s contact person’s name, title, telephone number and email address. NO PAYMENTS WILL BE MADE TO THE CONTRACTOR BY THE VILLAGE UNLESS AND UNTIL ALL OF THE CERTIFICATIONS FOR THE CONTRACTOR AND SUBCONTRACTORS HAVE BEEN COMPLETED.
An MBE/WBE/PDBE/VOSB is a business enterprise that meets one of the below requirements. Please select your business' DBE classification type.
Minority-Owned Business Enterprise (MBE) – A business that is at least 51 percent owned by one or more minorities. A person who is a U.S. citizen or lawful permanent resident and is African American, Hispanic American, Asian American, Native American, as well as other groups found to be disadvantaged pursuant to Section 8 (a) of the Small Business Act. Business Enterprise (MBE)
Women-Owned Business Enterprise (WBE) – A business that is at least 51 percent owned by a woman or women who are United States Citizens or lawful permanent residents of the United States.
Persons with Disabilities-Owned Business Enterprise (PDBE) – A business that is at least 51 percent owned by a person or group of persons with a disability, as recognized by the Americans with Disabilities Act, or as defined by the Commonwealth of Pennsylvania, Governor’s Office, Management Directive 205.25 Amended.
Veteran-Owned Small Business (VOSB) – A business that is at least 51 percent owned by one or more veterans who are United States Citizens or lawful permanent residents of the United States.
Please select whether your business carries a classification of Disadvantaged Business Enterprise (DBE) based on the requirements above.
Enter the name of your business.
Enter the your Bensenville business vendor number if available
Enter your street number and street name for your business address information. (e.g. 100 Main Road, 1256 Elm Street, 308 4th Street, etc.)
If your business is in a multi-unit dwelling, enter your suite number for your business address information. (e.g. A, B, STE 101, Suite 301, Unit 1A, Unit 23, etc.)
Enter the name of the city for your business address information.
Enter the name of the State for your business address information.
Enter the Zip Code for your business address information. Format 00000 or 00000-0000.
Enter the first name of the authorizing individual submitting this information.
Enter the last name of the authorizing individual submitting this information.
Enter the title of the authorizing individual submitting this information.
Enter your email address for contact information and receiving an email of this submittal.
Enter the telephone number of the authorizing individual submitting this information (e.g. 000-000-0000).
I hereby certify that the information supplied is complete and correct to the best of my knowledge and belief. I authorize the Village of Bensenville to verify any of this information as needed.
This field is not part of the form submission.
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