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Instructions Clear Form Michigan Department Of Transportation 4106 (10/12) Page 1 of 9 SMALL BUSINESS PROGRAM APPLICATION This form is used to determine eligibility of non-Disadvantaged Business Enterprises.

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How to fill out the Mdot Forms Search online

The Mdot Forms Search is a critical online application for small businesses seeking to participate in the Michigan Department of Transportation Small Business Program. Completing this form accurately is vital for determining eligibility and ensuring your business is considered for such projects.

Follow the steps to successfully fill out the Mdot Forms Search online.

  1. Click the ‘Get Form’ button to obtain the form, which will allow you to open it for editing.
  2. Enter the name of your business in the appropriate field. Make sure to provide the legal name as registered.
  3. Fill in the address of your business, including the city, state, and ZIP code.
  4. Provide the name and title of the authorized signer for your business along with their contact information, including telephone and email address.
  5. Indicate the federal year-end tax date for your business, specifying the month and day.
  6. Describe the major products or services your business provides, and include the NAICS code related to your business activities.
  7. List the names and addresses of the owners, partners, and principal stockholders of your organization, noting the type of partnership.
  8. Provide the names and addresses of all officers in your organization.
  9. If applicable, list the names of the board of directors if your business is a corporation, along with their addresses.
  10. Fill out the small business size determination by reporting your business's gross receipts for the three most recent fiscal years, including necessary tax forms as evidence.
  11. Complete the sections related to any affiliates or subsidiaries, specifically noting gross sales or receipts for the past three fiscal years.
  12. At the end of the form, certify that all information provided is accurate and true to the best of your knowledge, including your signature and the date.
  13. Once completed, save your changes, and consider downloading or printing the form for your records or for submission.

Take the next step in securing your business's future by completing the Mdot Forms Search online today!

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Acting Director Brad Wieferich, P.E., is the chief operations officer of the Michigan Department of Transportation (MDOT), overseeing MDOT's seven regions, the Bureau of Development, the Bureau of Field Services, and the Bureau of Bridges and Structures.

The Michigan Department of Transportation (MDOT) is responsible for Michigan's nearly 10,000-mile state highway system, comprised of all M, I, and US-routes. It is the backbone of Michigan's 120,000-mile highway, road and street network.

Send questions to MDOT by filling out the online form below or calling 517-241-2400.

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