Apex Accelerator - Cedar City office
Intent to Receive PTAC Client Services
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Company Name:
Point of Contact:
Position Title:
Physical Address:
City:
State:
Zip:
County:
Same as Physical Address:
Mailing Address:
City:
State:
Zip:
County:
Work Phone:
Fax:
Cell Phone or Pager:
E-Mail Address:
URL/Web Address:
Avg # of Employees (last 3 yrs):
Avg Yearly Gross Sales (last 3 yrs):
Date Business was Established:    [YYYY-MM-DD or MM/DD/YY]
DUNS Number:
CAGE Code:    Search for your DUNS Number and CAGE Code
Owner's Years Experience in Field:
Business Ownership:
Check all that apply. (Defined as 51% owned and controlled.)
Woman-owned Minority-owned Veteran-owned
Service Disabled Veteran-owned
Business Certifications and Determinations:
Check all that apply.
Disadvantaged Business
Distressed
Certified HUBZone
Small Business

Have you previously done business with any government agency or prime contractor?
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Generally describe or list the Products or Services you wish to offer to the government:
 
List the types of services you might want to receive from our center:
 
How did you hear about us?
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Service Commitment
What to expect... What we expect...
  • Individualized business counseling
  • Support with bid proposals
  • Information on all government levels: local, state, and federal
  • Identification of bid opportunities
  • Registrations & Certifications
  • Training events
  • Networking / matchmaking events
  • Federal Acquisition Regulations
  • Procurement Award History
  • Confidentiality concerning your company pertaining to any third party, with exception of our funding sources, without express consent by your company
  • Communication
    • Meet with Apex Accelerator - Cedar City office and receive at least 30 minutes of counseling time and/or attend a Apex Accelerator - Cedar City office event every 12 months.
    • Changes in your company's POC
    • Let us know your service needs
    • Updates in Company Capabilities
  • Return our Survey
    • How is it going?
    • Report any Federal, State or Local Contract or Subcontract Awards Information
I understand that if the expectations of this Service Commitment are not met, PTAC reserves the right to change my status from Active to Inactive. By submitting this form, I certify the above information is correct.
 
 Please check this box to verify you agree to the Service Commitment then click Submit to complete your Intent to Receive PTAC Client Services.