MBDA CRP Client Transaction Verification Form

Client Transaction Verification Form
Access to CapitalAccess to NetworksCapacity BuildingOther
For transactions in which the services provided by MBDA CRP, either directly or indirectly, resulted in either a contract or capital award, please answer the following questions:
Contract Award
YesNo
StandardMultiple/Multi-YearIDIQ
If yes, what was/were the Dollar Amount(s) of the award(s)?
Capital Award

(loan, bonding, equity, or other)
YesNo
If yes, what was/were the Dollar Amount(s) of the capital obtained?
Job Opportunities
New Jobs Created
Jobs Retained
Pursuant to the client responsibilities outlined in Section (d) of the MBDA CRP Internal/External Client Engagement Form, please provide all documentary evidence (contract award documents, agreements, etc.) to your servicing MBDA CRP Awardee as evidence of the above transaction(s). All documentation will be kept on file and confidential within the MBDA. MBDA and MBDA CRP will take reasonable action to restrict access to such information by non-governmental entities. All information will remain confidential to the fullest extent of the law.
Please provide a brief narrative description of the MBDA CRP services provided to your firm:*
I hereby certify that the information and statements provided in this document are truthful and accurate representations of the transaction(s) that occurred as a result of MBDA’s services. I also certify that all verifying documents are authentic and accurately represent the transaction(s) referenced above.
Client Firm Name*
Authorized Client Representative Name*

First NameLast Name
Title*
Email*
Date*

MonthDayYear
Date
Signature*

Clear
I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law.
Should be Empty:

Client Transaction Verification Form

Contract Award

Capital Award

Job Opportunities