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Business Center Internal/External Client Engagement Form

Minority Business Development Agency Business Center Program Services

Business Center 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 minority business enterprises (MBEs). MBDA accomplishes its mission by funding and working cooperatively with Business Centers that assist clients that are socially or economically disadvantaged, regardless of race or ethnicity, by 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, Business Centers help clients to achieve their growth objectives by connecting them with prospective strategic partners through business-to-business matching, teaming arrangements, joint ventures, or other strategic advisory services.

    Acknowledgement of Client Relationship

    (“client”) has engaged with the Business Center (“Business Center”) for business consulting or other services. The services provided by Business Center to the client are subsidized through Federal appropriations. MBDA-funded Business Center agrees to provide one or more of the following services:

    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 Business Center (as demonstrated in this agreement); (b) provide firm contact and profile information; (c) disclose to MBDA and/or Business Center outcome(s) based on the services provided to the client by Business Center to MBDA; and (d) provide documentary verification to MBDA and/or Business Center for transactions resulting from services provided pursuant to this engagement.


    Under this agreement, the client certifies under penalty of perjury that it is a minority business enterprise (MBE), as defined by the MBDA Act. 15 U.S.C. §§ 9501(9), (15). A minority business enterprise (MBE) under the MBDA Act is a business enterprise majority-owned and controlled by at least one socially or economically disadvantaged individual. 15 U.S.C. § 9501(9). A socially disadvantaged individual is an individual who has been subjected to racial or ethnic prejudice or cultural bias because of the identity of the individual as a member of a group, without regard to any individual quality of the individual that is unrelated to that identity. 15 U.S.C. § 9501(15). An economically disadvantaged individual is an individual whose ability to compete in the free enterprise system been impaired due to diminished capital and credit opportunities, as compared to others in the same line of business and competitive market areas, because of the identity of the individual as a member of a group, without regard to any individual quality of the individual that is unrelated to that identity. 15 U.S.C. § 9501(15). An individual of any race or ethnicity may meet the definition of socially or economically disadvantaged under the MBDA Act.

    Privacy Disclosure and Information Use

    By submitting this form, your company agrees to allow the Business Center 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 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 Business Centers 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 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