Pinnacle West Capital Corporation is seeking minorities, women, veterans, service-disabled veterans and HUBZone enterprises that  provide high quality products and services at competitive prices.  Suppliers interested in pursuing business opportunities are encouraged to ensure their product or service is procured by PNW by reviewing the list of products and services PNW normally buys.

While completion of this Submittal Form does not guarantee future opportunities, it is required for supplier consideration.  Pinnacle West commits to evaluating your Supplier Submittal Form to ascertain if there is an opportunity and to contact you if it is determined that there is a match between your product or service and our business needs.

	* required information
	* Firm Name or DBA
	Principal Product or Service
	Secondary Product or Service
	* Street Address
	* City		* State AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NF - Newfoundland NS - Nova Scotia NT - Northwest Territories NU - Nunavut Territory ON - Ontairo PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon Territory
	* Zip Code
	* Phone		Fax
	E-mail		Web site
	Year Business Established		Number of Employees
	* Contact Person		Contact Person Title
	* Companies wishing to apply must be 51 percent owned, controlled or operated by one or more of the following (please indicate which one applies to your business)
	African American		Asian-Indian American
	Native American		Hispanic American
	Women		Asian-Pacific American
	Service Disabled Veteran		Veteran
			Not Applicable
	Are you certified as any of the following in the CCR Dynamic Small Business Search Database (formerly known as the SBA PRO-NET Database)?
	8a	SDB	WBE	HUBZONE
	Veteran	Disabled Veteran	Vietnam Veteran
	(Please forward a copy of your SBA or MBWE certifications to Supplier Diversity & Development)
	Is your firm certified as a Minority, Women, Veteran, Service-Disabled Veteran or HUBZone Business by any of the following?
	Grand Canyon Minority Supplier Development Council/NMSDC
	Women's Business Enterprise Council West/WBENC
	City of Phoenix
	Other minority/women business councils:        Name
	Proof of certification must be submitted electronically to suppdiv@apsc.com within 15 days after submitting this form.
	* Federal Tax ID Number		DUNS Number (9 digits)
	* NAICS Code		Dun & Bradstreet credit rating
	Annual Gross Revenue
	Business Reference 1
	Company Name		Product/Service Provided
	Contact Name		Phone
	Business Reference 2
	Company Name		Product/Service Provided
	Contact Name		Phone
	The undersigned declares that all statements are true and correct. The undersigned agrees to notify APS, a subsidiary of Pinnacle West Capital Corporation, immediately of any changes to the information contained herein, particularly change in ownership, controlling interest or operations. To change or update your registration please contact us at suppdiv@apsc.com.
	* Your initials