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REACH Application

8. Entity Type
11. Is your business woman-owned?
12. Is this business 51% minority owned?
13. If yes, please check the appropriate category: 
14. Does your firm need financing? 
15. Does your firm currently have bonding?
17. Do you have any of the following certifications? Please select all that apply.
REACH Program Disclaimer & Acknowledgements

1. ATTEST
The undersigned attests that they desire to participate in the REACH program and that the information it provides to REACH is accurate and true.  The Undersigned recognizes that institutional and governmental agencies may rely upon the accuracy of the information provided to make decisions and that knowingly providing false information can be construed as fraud and may be punishable to the maximum amount allowed under the laws of State of Nebraska.  Misrepresentations by the REACH Participant may be grounds for the REACH Participant(s) being barred from further participation in the REACH program, the Nebraska Enterprise Fund’s loan programs, and the REACH Partner organizations being notified of the participant’s actions.

2. INDEMNIFICATION
The undersigned will indemnify, defend, and hold the REACH Program and the REACH Partner organizations harmless from all claims, demands, causes of action, debt, or liability arising from any third-party claims, including those that any equipment, services or processes used by REACH in providing the specified Services infringes or misappropriates any intellectual property rights of any third party. 

It is understood by the undersigned that the services provided by REACH are educational in nature and in many cases the information provided is reliant upon information provided by the REACH participant.  Information may be tailored specifically for an individual REACH participant and is not intended to be applicable to any other individual or entity.   Information provided and the results of individual and/or group sessions is not guaranteed or warranted and it is not implied that said information should be utilized beyond the purpose of reference.

The undersigned will indemnify, defend, and hold the REACH Program and all of its assigns harmless from all claims, demands, causes of action, debt, or liability arising from any claims arising from service performed, or not performed.  

3. PRIVACY
Private information provided by the REACH Participant is kept private and is not subject to public review or dissemination without authorization by the REACH Participant.  All information provided by the REACH Participant is subject to aggregation and submittal to the REACH Partner organizations as a representation of the group of participants and/or the work performed on their behalf.  A list of individual firms receiving assistances may be reported to REACH Partner organization’s program administrator as part of a periodic reporting process.  Information provided by the REACH Participant regarding a bid, contract, credit extension, acquisition of bonding, negotiation or other service may require the sharing of information with REACH Partner organizations and/or appropriate third parties.  The REACH Participant agrees to information dissemination to necessary parties.