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Vendor/Contractor Requirements

Vendor Form

For New Vendors Only

Supplier Information

UR Medicine Home Care, as a contractor to the US Government, is required to collect and report supplier size information for certain subcontracting reports.

Required fields marked with asterisk (*)

Small Disadvantaged Business?*:

Hub Zone Small Business (SBA Certified)?*:

Woman Owned Small Business?*:

Veteran Owned Small Business?*:

Alaska Native Corporation?*:

Indian Tribes?*:

Second Tier Program?*:

Certified? (Federal, State, Regional)*:

You may wish to review the definitions for the above categories in the Federal Acquisition Regulation 19.7 or 52.219-8 ( If you have difficulty ascertaining your size status, please call 1-800-U-ASK-SBA or refer to SBA's website.

Contact Information

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*Does any UR Medicine Home Care (URMHC) employee, or a close relative or member of his or her household, who has or will participate in the decision to acquire goods and/or services from your company (1) own 5% (or more) stock or other interest in your company (2) serve as an officer, director, employee, proprietor, partner, trustee, or consultant of your company; (3) stand to profit financially or personally in any way from the acquisition by the University of goods and/or services from your company; or (4) receives compensation in any form or in any amount from your company?

*Any situation where a University of Rochester staff or its affiliates, faculty or student and/or his or her spouse or emancipated and /or minor children has a connection to the above referenced supplier.

If you answered yes, please complete the following section:

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Under 15 U.S.C. 645(d), any person who misrepresents its size status shall (1) be punished by a fine, imprisonment, or both; (2) be subject to administrative remedies; and (3) be ineligible for participation in programs conducted under the authority of the Small Business Act.

Company Representative Information

Company representative submitting this information and validating that this information is correct:

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Please send copies of brochures and certifications to: URMHC, 2180 Empire Blvd., Webster, NY 14580. Or email to Questions can be directed to URMHC-Contracts.