Business Name:
Point of Contact:
Address:
City:
State:
Zip Code:
Phone:
Fax:
Email:
Please indicate the basis of the success story and provide the applicable information:
1. Based on procurement/contract award?

2. Based on procurement /contract issue?
YesNo
PLEASE DESCRIBE THE ISSUE(S) THE MPTAP ASSISTED YOUR COMPANY IN RESOLVING.
3. How many jobs were generated or rerained as a results of the MPTAP's Assistance?
4.(i) The MPTAP is authorized to publish the content of the success on its website and /or other literature.
YesNo
4.(ii) I attest that the success story is true and that the success resulted from substantial effort from the MPTAP.
YesNo