Supplier Classification Form

Dear Valued Supplier,

Intuitive Surgical is now required to submit subcontracting information to the Government.

Please see below two classifications and choices. Your selection should based on your company status as of your last Fiscal Year End:

*Company Name:

*Company Contact:

*Category:

Small Business (SB)	Small Disadvantaged Business (SDB)
Woman-Owned Small Business (WOB)	Veteran-Owned Small Business (VOSB)
Service Disabled Veteran-Owned Small Business	Historically Underutilized Business Zone (HUBZone) Business
Disadvantaged Business Enterprises (DBE’s)	None of the Above

*General Business Category:

For definitions of the terms above, please go to: http://osdbuweb.dot.gov/about/customers.cfm#SDB

Thank you for your continued support,

Accounts Payable

Questions? Please contact Accounts Payable at 408-716-2779 or email AP.vendorclass@intusurg.com.