2011 Small Business Success Story

Application deadline: January 18, 2012.

This completed and submitted application will be used by the NDIA Small Business Division to select and publish stories about successful small businesses that have provided direct impact to supporting the warfighter. Please do not provide any intellectual property in this application as stories will be shared publicly. It is important to note that all stories will be vetted with the customer point-of-contact provided in this application. As this is a competitive process, we recommend quantifiable details wherever possible.

Questions regarding the program and/or application may be submitted to Rebecca Danahy, Meeting Planner, NDIA, at rdanahy@ndia.org.

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1. Name and Address of Small Business Nominee

Name and Address of Small Business Nominee Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:

*
2. Name of Principal Officer or Owner

Name of Principal Officer or Owner Name:
Email Address:
Phone Number:

*
3. Contact information for the person submitting the application

Contact information for the person submitting the application Name
Phone number
Email address

*
4. Name and Address of Customer

Name and Address of Customer Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

*
5. Name of Project

Name of Project

*
6. Number of years in the business

Number of years in the business less than 2

2 - 5

6 - 10

10+

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7. Annual average (past 3 years) revenue

Annual average (past 3 years) revenue less than $500K

$501K - $1M

$1.1 - $2M

$2.1 - $5M

$5.1 - $12M

$12.1M - $23M

$23.1M - $50M

$50.1M - $200M

$200.1M+

*
8. Current number of full time employees

Current number of full time employees less than 10

11 - 20

21 - 50

51 - 100

101 - 250

251 - 500

501 - 1,000

1,001 - 1,500

1,501+

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9. Please select the categories that the small business falls into

Please select the categories that the small business falls into Small Business

Woman-Owned

Service Disabled Veteran-Owned

8(a)

Small Disadvantaged Business

Veteran-Owned

HUBZone

Native American

Other (please specify)

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10. Rank in order the top three (3) categories where the small business currently provides products & services.

	1	2	3
Air Force	*Rank in order the top three (3) categories where the small business currently provides products & services. Air Force 1	Air Force 2	Air Force 3
Marine Corps	Marine Corps 1	Marine Corps 2	Marine Corps 3
Department of Homeland Security	Department of Homeland Security 1	Department of Homeland Security 2	Department of Homeland Security 3
Army	Army 1	Army 2	Army 3
Coast Guard	Coast Guard 1	Coast Guard 2	Coast Guard 3
Navy	Navy 1	Navy 2	Navy 3
Intelligence Agencies	Intelligence Agencies 1	Intelligence Agencies 2	Intelligence Agencies 3
Other	Other 1	Other 2	Other 3

If other(DARPA, SOCOM, DTRA, DLA), please specify

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11. Describe the nature of your business

Describe the nature of your business Professional Services/Consulting

Armaments

Ballistics

Bomb & Warhead

Chemical Biological Defense

Combat Survivability

Combat Vehicles

C4ISR

Environment and Energy

Expoditionary Warfare

Health Affairs

Homeland Security

Information Technology

Logistics

Manufacturing

Missile Defense

Munitions

Robotics

Space

Special Operations/Low Intensity Conflict

Strike, Land Attack, and Air Defense

Systems Engineering

Tactical Wheeled Vehicles

Targets, UAVs, & Range Operations

Test and Evaluation

Undersea Warfare

Other

If other please specify

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12. Specifically identify the month and year of the project start and completion date. Use "ongoing" if the project is still in progress. The project should be within the last 24 months.

Specifically identify the month and year of the project start and completion date. Use "ongoing" if the project is still in progress. The project should be within the last 24 months.

*
13. Describe how this project's success directly or indirectly supports the warfighter.
(200 words or less)

Describe how this project's success directly or indirectly supports the warfighter. (200 words or less)

*
14. Describe the need the project fulfills/why the project was started.
(200 words or less)

Describe the need the project fulfills/why the project was started. (200 words or less)

*
15. Describe the approach and solution to the project need.
Do not provide any information that may be considered intellectual property. Feel free to provide pictures/graphics if they assist in describing the story. These may be submitted via email to Rebecca Danahy at rdanahy@ndia.org. Do not provide any marketing material.
(500 words or less)

Describe the approach and solution to the project need. Do not provide any information that may be considered intellectual property. Feel free to provide pictures/graphics if they assist in describing the story. These may be submitted via email to Rebecca Danahy at rdanahy@ndia.org. Do not provide any marketing material. (500 words or less)

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16. Provide quantitative results, if possible, to describe what savings/benefits/value the project provided. Examples such as $1.2 M in savings, 50% increase in productivity, or 200% improvement in safety, etc. are appropriate and recommended as long as they can be verified with the customer.
(200 words or less)

Provide quantitative results, if possible, to describe what savings/benefits/value the project provided. Examples such as $1.2 M in savings, 50% increase in productivity, or 200% improvement in safety, etc. are appropriate and recommended as long as they can be verified with the customer. (200 words or less)

*
17. Describe the extent of the project impact.
Was it something that provided positive benefits to all military personnel (e.g. electronic health records)? Was it something that provided success in a very specific environment (e.g. Navy aircraft improvement)?
(50 words or less)

Describe the extent of the project impact. Was it something that provided positive benefits to all military personnel (e.g. electronic health records)? Was it something that provided success in a very specific environment (e.g. Navy aircraft improvement)? (50 words or less)

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2011 Small Business Success Story

*1. Name and Address of Small Business Nominee

*2. Name of Principal Officer or Owner

*3. Contact information for the person submitting the application

*4. Name and Address of Customer

*5. Name of Project

*6. Number of years in the business

*7. Annual average (past 3 years) revenue

*8. Current number of full time employees

*9. Please select the categories that the small business falls into

*10. Rank in order the top three (3) categories where the small business currently provides products & services.

*11. Describe the nature of your business

*12. Specifically identify the month and year of the project start and completion date. Use "ongoing" if the project is still in progress. The project should be within the last 24 months.

*13. Describe how this project's success directly or indirectly supports the warfighter.(200 words or less)

*14. Describe the need the project fulfills/why the project was started.(200 words or less)

*17. Describe the extent of the project impact.Was it something that provided positive benefits to all military personnel (e.g. electronic health records)? Was it something that provided success in a very specific environment (e.g. Navy aircraft improvement)?(50 words or less)