DATE:
TO: Orange County Business Development Division
P.O. Box 1393; 400 E. South St., Orlando, FL 32802-1393
Fax: 407- 246-5219
FROM: __________________________________________
Name
__________________________________________ _____________
Company Name Vendor Number
SUBJECT: Name/ Address/ Status Change
Please note the following changes regarding my firm and include them in your next update of the
Orange County M/WBE Certification Directory. Only complete the section(s) below that has
changed in your company.
Name : _______________________
Address: _______________________
(number, street/avenue)
___________________
(suite or apt. no.)
___________________
(City State and ZIP code)
Phone: ( ) ___________________
Fax: ( ) ________________________
E-mail address: __________________
Website address: ____________________________________________________________
Ownership: __________________________________
*Additional documentation will be required and you will be contacted*
Change in Scope: __________________
*Additional documentation will be required and you will be contacted*
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