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Tellabs Supplier Diversity Profile

In order for Tellabs to respond to your request as fast and effectively as possible, please fill out as many fields as possible. Fields marked with an * are required.



Where did you hear about Tellabs?
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Other:
Primary Contact:
First Name:*
Last Name:*
Job Title:*
Phone:*
Fax:*
Email:*
Company Information:
Company Name:*
Division:
Address:*  (No PO Box)
Address 2:
City:*
State/Province:*
Zip/Postal:*
Country:*
Phone:*
Fax:*
Website:*
Year Established:*
Tax ID Number:
DUNS Number:*
Legal Structure:*
Is your company publicly traded?:*
Number of Employees:*
Annual Revenue:*
Gross Sales YTD:*
Gross Sales For The Past Three Years *
2009:
2008:
2007:
Company Affiliations:
Is your company a subsidiary of a parent company?:* 
If yes, what is the name of the parent company?: 
If yes, what is the primary business of the parent company?: 
Does your company have any subsidiaries or affiliates?:* 
If yes, please include the following information for each subsidiary or affiliate.
Company:
Address:
City:
State:
Zip/Postal:
Country:
Contact:
Phone:
Fax:
Company:
Address:
City:
State:
Zip/Postal:
Country:
Contact:
Phone:
Fax:
Company:
Address:
City:
State:
Zip/Postal:
Country:
Contact:
Phone:
Fax:
Company:
Address:
City:
State:
Zip/Postal:
Country:
Contact:
Phone:
Fax:
Products/Services:
Type of business:*
Other:
Standard Industrial Classification (SIC) Codes:
Code No. 1* Code No. 2 Code No. 3 Code No. 4 Code No. 5
North American Industry Classification System (NAICS) Codes:
Code No. 1* Code No. 2 Code No. 3 Code No. 4 Code No. 5
Geographic Service Areas:
Local:*  If yes, specify:
Regional:*  If yes, specify:
National:*  If yes, specify:
International:*  If yes, specify:
Certifications:
Is your company a Minority Business Enterprise?:* 
Is your company a Small Business Concern,
pursuant to Section 3 of the Small Business Act (SBA)?:* 
Diversity Certification:*  Gender:* 
Certifying Agency 1:*  Expires:*   
Certifying Agency 2:  Expires:   
Certifying Agency 3:  Expires:   
SBA Certification:*  Expires:*   
Other Certification 1:  Expires:   
Other Certification 2:  Expires:   
Quality Certifications:*
Other:
Tellabs Relationship:
Has your company done any business with Tellabs?:* 
If yes, please provide the following:
Entity/Department:
Location(s):
Agreement Type:
Agreement Number:
Status:
Start Date:
Expiration Date:
Products/Services provided:
Revenue associated with Product/Services provided:
Current Year Estimated:
Prior Year Total:
Tellabs contact name(s):
References (Major Customers):
Company Name:*
Contact:*
Phone:*
Products/Services Sold:*
Company Name:*
Contact:*
Phone:*
Products/Services Sold:*
Company Name:
Contact:
Phone:
Products/Services Sold: