Partnering With Avaya Government Solutions

* Consideration as a teaming partner for an immediate opportunity?:	Yes No
If for an immediate opportunity please provide details:
Date:	7/29/2010

Primary Partnering Contact:
* Name (Last, First):
* Title:
* Phone Number:
Fax Number:
* Email:
Is contact address different than that above?:	Yes No
If yes, complete additional address items:
Address 1:
Address 2:
City:
State:
Zip Code:
Country:

Primary BD/Sales Contact:
* Name (Last, First):
* Title:
* Phone Number:
Fax Number:
* Email:
Is contact address different than that above?:	Yes No
If yes, complete additional address items:
Address 1:
Address 2:
City:
State:
Zip Code:
Country:

President/CEO:
* Name (Last, First):
* Title:
Other (i.e COO, V.P. Operations, V.P. Sales, etc.)?:	Yes No
* Phone Number:
Fax Number:
* Email:

* Primary Business:	IT Non IT Hardware Software Products Services
* Year company established:
State/Province/County of Incorporation:
Has company had a name change in the past 12 months?:	Yes No
Previous company name:
* U.S. ownership?:	Yes No
* U.S. headquartered?:	Yes No
In which states and countries is business done?:
* Company Line of Credit?:	Yes No
* Venture Capital-backed?:	Yes No
* Does the company have a facility clearance?:	Yes No
If yes, at what level?:	Secret Top Secret
* Number of employees:
* Number of employees with security clearances:
* Company Fiscal Year:
* Last Fiscal Year revenue:
* Average 3 year revenue:
* Percentage of Revenue from Government:	20% 30% 50% 55%+
* Percent of Revenue from IT:	20% 30% 50% 55%+
CAGE #:
* DUNS #:
* Federal Tax ID # or EIN or Social Security Number (no dashes):
if SSN, Name of SSN owner:
* Company Differentiators: i.e. Gartner, SEI CMM, ISO etc.:
* Prime GWAC Vehicles?:
* GSA schedules?:

* Business Size:	Large Small
* Business Type:	Foreign-Owned Minority Owned Women-Owned Service Disabled Veteran Owned (VA Certification) SDB 8(a) HCBU HUBZone-(SBA Certification) Native American Alaska Native Corporation (ANC)
* Central Contract Registration (CCR) registry?:	Yes No http://www.ccr.gov
Graduation/Exit date:

* NAICS Codes and US NAICS Title: (Please separate NAICS codes with a comma, e.g. 421610,421720, etc.):
* Core Capabilities:
* Products/Services:
* Give an overview of product/service offering:
Provide Key features/attributes associated with products/services:
* Key Discriminators:

* List five (5) Major Federal customers:
List geographic locations where work is being preformed:
Existing/Past Business with Government Agency:
Agency:
Contract Name:
Contract #:
Contract Value:
Date of Performance (Start, End):
Identify GWAC/GSA Schedule/vehicle (if applicable):
Contact Name:
Contact Phone:
Contact Email:
Business History with Avaya Government Solutions:
Existing/Past Business with Avaya Government Solutions?:	Yes No
If yes, provide the following:
Contact Name at Avaya Government Solutions:
Contract #:
Contract Value:
Date of Performance (Start, End):
Existing/Past Business with Commercial Companies:
Provide the following information for companies which you have done business with:
Company Name:
Contact Name:
Contact Title:
Contact Phone:
Contact Email:
Contract #:
Contract Value:
Date of Performance (Start, End):