Solicitud de servicios

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Request for Services

Por favor rellene la siguiente forma para solicitar nuestros servicios:

Name(Required)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Cell

Email(Required)

Gender Identification

This field is hidden when viewing the form

Minority/Ethnic Classification

Services Requested

Business Plan Development

Construction Assistance

Franchise Development

Other Financial

Loan Packaging

Procurement Assistance

Marketing

Strategic Planning

Market Research/Feasibility Analysis

Other

Requesting a Loan

Yes

No

Company Info

Company Name

Company Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email(Required)

Website

Business Start Date

MM slash DD slash YYYY

Accounting Period Closes (Mo)

Business Type

State of Incorporation

Is your business Minority certified (MBE)?

Yes

No

If yes, please indicate with which agencies:

Clark County

State of NV

NDOT

8(a) Federal

City of LV

NMSDC

Type of Business

Check all that apply

Manufacturing

Service

Construction

Retail

Franchise

Keywords (that best describes your business)

Number of Full-Time Employees

Number of Part-Time Employees

Number of Minority Employees

Annual Sales $

Annual Export Sales $

Largest Contract Value (In last 3 years)

Maximum Bonding Level $

Current Bonding Level $

Accept Government Credit Card

Yes

No

Facilities Security Level

None

Top Secret

Secret

Confidential

Other

Duns#

Value Added Network #

CAGE Code

Consent(Required)

This form demonstrates my company's intent to be a Client of the Nevada MBDA Business Center, and is not a binding contract between the parties. Nevada MBDA Business Center will provide assistance to me as agreed upon by my company and Nevada MBDA Business Center. Assistance is detailed in service agreements which are executed between the parties. I verify that the information provided above is accurate to the best of my knowledge.

Full Name

Signing Date(Required)

MM slash DD slash YYYY

The services provided by MBDA Business Centers to clients are subsidized through Federal appropriations. Fees charged are based on the service provided and the client’s gross sales. Contact us for more details.

Please note all firms must formally register as clients by completing an application form.

Los servicios proporcionados por el Centro de Negocios MBDA a los clientes están subsidiados a través de asignaciones federales. Las tarifas que se cobran se basan en el servicio ofrecido y las ventas brutas del cliente. Contáctenos para conocer los detalles.

Tenga en cuenta que todos los negocios deben registrarse formalmente como clientes completando un formulario de solicitud.

Location

555 N. Maryland Parkway
Las Vegas, NV 89101
(702) 551-2307

UBICACIÓN

555 North Maryland Parkway
Las Vegas, NV 89101
(702) 551-2307

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