The document is a form that requires the sender to provide information about their business to Chesterfield County for statistical purposes. The form includes sections for the order from address, remit to address, and the sender's signature. It also asks for the sender's name, title, federal ID number, phone number, and fax number. The form includes checkboxes for the sender to indicate if their business is a minority business enterprise, woman-owned business, or a Chesterfield business. The document emphasizes that all firms submitting bids will receive equal consideration.