NonSubstantive Change for MBDA CRP Client Engagement For

Minority Business Development Agency Capital Readiness Program Services
MBDA CRP Internal/External Client Engagement Form
The U.S. Department of Commerce Minority Business Development Agency’s (MBDA) mission is
to foster the growth and global competitiveness of U.S. businesses that are minority-owned. MBDA
accomplishes its mission by funding and working cooperatively with CRP Awardees that assist
clients with facilitating transactions through referrals, business consulting, contract bid/proposal
preparation, loan packaging, and/or matching contract opportunities and capital sources (i.e.,
loans, equity, bonding, etc.). In addition, MBDA CRP Awardees help clients to achieve their
growth objectives by connecting them with prospective strategic partners through business-tobusiness matching, teaming arrangements, joint ventures, or other strategic advisory services.
Acknowledgement of Client Relationship
(“client”) has engaged with MBDA Capital
Readiness Program (CRP) Awardee
for
business consulting or other services. The services provided by MBDA CRP Awardee to the
client are subsidized through Federal appropriations. MBDA CRP Awardee agrees to provide one
or more of the following services:
__Access to Capital

__Access to Network

__Capacity Building

__ Other

MBDA does not guarantee any particular outcome or business result on behalf of the client or
associated third parties and is not liable for any outcomes or business decisions made by the client
or associated third parties.
Acceptance of Client Relationship
The client agrees to: (a) acknowledge the relationship with MBDA CRP Awardee (as demonstrated
in this agreement); (b) provide firm contact and profile information; (c) disclose to MBDA CRP
Awardee outcome(s) based on the services provided to the client by MBDA CRP Awardee; and (d)
provide documentary verification to MBDA CRP Awardee for transactions resulting from services
provided pursuant to this engagement.
Privacy Disclosure and Information Use
By submitting this form, your company agrees to allow the MBDA CRP Awardee and/or MBDA to
share this document, information contained therein, and any supplementary material provided by
your company (collectively “Client Engagement Form”) on an as needed basis, with other United
States Government agencies to carry out appropriate due diligence and more effectively advocate for
your interests. The Client Engagement Form also may be used by MBDA and/or MBDA CRP
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OMB CONTROL NUMBER: 0640-0002 Revision approved date: 02/01/2024 Expiration Date: 01/31/2026

Awardee for the purposes of conducting research, studies, and analysis consistent with the MBDA
mission as stated in the MBDA Act. The Client Engagement Form is considered business
confidential and will not be shared with any other person or organization outside the U.S.
Government unless the MBDA is given permission to do so by your company. All business
confidential information will be protected from disclosure to the extent permitted by law.
Public Burden Statement
According to the Paperwork Reduction Act of 1995, no person is required to respond to a collection
of information unless it displays a valid Office of Management and Budget control number. Public
reporting burden for this collection of information is estimated to average 10 minutes per response,
including time for reviewing instructions, searching existing data sources, gathering, and
maintaining the data needed, and completing and reviewing the collection of information. Your
response is voluntary. Send comments regarding the burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, to the:
Minority Business Development Agency
Office of the Chief Operating Office
Attention: Information Management Division:
1401 Constitution Avenue, N.W., Room 5612
Washington, DC 20230

Signature of Authorized Client Representative

Date

Print Name of Authorized Client Representative

Name of Business

Address
City, State, Zip
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OMB CONTROL NUMBER: 0640-0002 Revision approved date: 02/01/2024 Expiration Date: 01/31/2026

Telephone
E-Mail

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OMB CONTROL NUMBER: 0640-0002 Revision approved date: 02/01/2024 Expiration Date: 01/31/2026