APP-08846
GMS Test
GMS Test
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Application Id:
Applicant:
Contact:
Phone:
Email:
Application Status:
Review Notes:
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AI ESC Application: GMS Test
Draft
Company Name and Contact Info
Question 1: Provide legal business name of company applying for Early Stage and Retention Company (ESRC) Advanced
Industry (AI) Grant.
GMS Test
Question 2: Business Street Number
555 Main Street
Question 3: Business City.
Denver
Question 4: Name the County in Colorado which contains the business's primary Colorado location.
Not Answered
Question 5: Business State/Province.
CO
Question 6: Business Zip/Postal Code (zip +4)
80202
Question 7: Business Country.
A
Not Answered
Question 8: Name of Contact Person for Application.
Not Answered
Question 9: Phone Number of Contact Person for Application.
Not Answered
(GMS Test) Page 1 of 12
Question 10: Please upload a signed copy of the application certification form found in the Resources section in PDF
format.
No Attachments
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Question 11: If application is a Sole Proprietor or if any individual owns more than 20% of the company upload a signed
copy of the credit investigation form found in the Resources section for each such person.
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No Attachments
Question 12: Check the box that describes your company's legal structure. The information in the () describes the legal
documents which should be uploaded in the next question.
LLC (Filed Articles of Organization with Colorado Sectetary of State (CO SOS) )
C or S Corp. (Resolution + filed Articles of Incorporation + Corporate By-Laws filed with CO SOS)
Sole Proprietorship (Filed Trade/Assumed Name Certificate with the Colorado Department of Revenue)
General Partnership (General Partner Agreement + Trade Name Certificate w/ DOR if applicable)
Limited Partnership (Filed Certificate of Limited Partnership with the Colorado Secretary of State)
Other (contract grant manager to inquire)
Question 13: Upload Legal Entity Structure Documentation in PDF or Word file format as described in the () in the
question above.
No Attachments
Question 14: Upload a signed W-9 form for the company.
No Attachments
Question 15: Unless you are a Sole Proprietor or a General Partnership, upload A Certificate of Good Standing from the
Colorado Secretary of State.
No Attachments
Project Info and Grant Amount
Question 16: Provide a Project Overview in three sentences or less
Not Answered
A
Question 17: What Advanced Industry sector does the company's technology and R&D apply to? You can select more than
one AI. If you select two or more AIs, the $250,000 ESRC award cap can be removed with evidence that your technology &
R&D applies to multiple AIs.
Advanced Manufacturing
Aerospace
Bioscience
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Electronics
Energy and Natural Resources (including Clean Technology)
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Information Technology
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Infrastructure Engineering
Question 18: If you selected "Energy and Natural Resources (including Clean Technology) is this a clean technology
company?"
Yes
No
Question 19: If two or more AIs were selected and you intend to apply for more than $250K in ESCR grants, please explain
how your company's technology and R&D directly applies to each AI with specific, detailed examples of products and
services.
Not Answered
Question 20: If two or more AIs were selected (& one was advanced manufacturing, electronics or IT) & you intend to
apply for more than $250K in ESRC grants, explain how the project directly impacts scalability, process improvements or
market adoption of the other AI.
Not Answered
Question 21: Is your company headquartered in Colorado or does your company have at least 50% of employees working in
Colorado? This is a requirement for grant eligibility.
Yes
No
Question 22: If you answered "Yes" to the question above about your headquarters or 50% of employees being in Colorado,
are your long term plans and expectations to maintain or grow these operations in Colorado?
Yes
No
Question 23: Does your company have annual revenues of less than $10 million? This is a requirement for grant eligibility.
Yes
A
No
Question 24: Has your company previously received less than $20 million from other grants and third-party investors? This
is a requirement for grant eligibility.
Yes
No
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Question 25: As part of your commercialization plan, select the Milestones your company has already achieved at the time
of this grant application. Please select ALL items that apply. You are required to achieve these Milestones before receiving
an ESRC grant.
Proof of Principle:extensively analyze technology's commercial potential, SWOT, resources required
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Intellectual Property Protection: IP strategy developed, IP protection process & filings in place
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Prototype & Technical Validation: working prototype created, functional/regulatory testing underway
Market Assessment:market, feasibility, regulatory, cost/scalability analysis b/o prototype functions
Start Up Functions: legal entity formation, IP & investor strategy, collateral & web site created
Question 26: Briefly explain how you achieved the Milestones that you selected in the question above. Customize your
answer based on the commercialization timelines and milestones that are relevant for your industry sector.
Not Answered
Question 27: What part of the early stage development spectrum is your company currently working on which this grant
would assist you with? The maximum grant you can apply for will be based on your development stage selected in this
question.
Model Refinement: creating engineering prototype, strategic marketing & business plans (max $50K)
Market Introduction: production prototype, market validation, install business systems (max $250K)
Commercial Activity: production, sales & distribution, revenue growth (max $250K)
Question 28: How much grant money are you applying for? You can only request up to the "Max" from the answer selected
in the question above unless your company's technology & R&D applies to two or more AIs in which case the cap can be
lifted.
Not Answered
Question 29: Do you currently have the full required dedicated matching funds (two or more times the grant amount you are
applying for) in cash in your bank account or documented in committed funding letters. Match must be cash (not in kind).
Yes
No, but I am applying for conditional approval & know full cash match is required within 6 months
No, cancel my application this cycle while I obtain matching funding (don't submit application)
Question 30: If you answered "no" to the question above & are applying for conditional approval, confirm that you
understand the terms listed in the answers below by selecting ALL of them. Otherwise your application for conditional
approval will be rejected.
A
Applying for conditional approval may reduce selection odds compared to having full match up front
If I receive conditional approval, I must obtain required match in my bank account within 6 months
If I do not demonstrate required match after six months, my conditional approval will be canceled
If I do demonstrate the full match within six months, I will receive a final award letter
(GMS Test) Page 4 of 12
After receiving a final award, I will comply with all the terms in the question immediately below
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Question 31: Confirm you understand the requirements listed in this question by selecting them in the answer below. Your
application will be rejected if you do not select ALL four items. Failure to comply with these terms will result in
cancellation of grant awards.
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I must have the full required cash match in my bank account when my grant agreement is exectuted
I must execute my grant agreement within 30 days of a final award letter
I can not spend or obligate my matching funds until I receive a final grant award letter
I can not spend or obligate any AI grant funds until my grant agreement is executed
Question 32: How much in dedicated confirmed matching funds do you have available as cash in your bank account or
documented in committed funding letters?
Not Answered
Question 33: What are the sources of these matching funds? Name the source, list the amount of the funds they are
providing and their contact phone numbers and emails.
Not Answered
Question 34: Upload documentation of your matching funds e.g. bank statements and/or committed funding letters in PDF
files. Note these documents should add up to your total available matching funds per the question above.
No Attachments
Question 35: Please select the number of months needed to complete the proposed project work after the grant agreement
has been executed. Round up to the nearest option. Do not select a term which is longer than is permitted based on industry
sector.
12 Months
24 Months (Max Term for Non-Bio-science company
36 Month (Max Term for Bio-science company)
Question 36: Please list your company's website URL here.
Not Answered
Question 37: Describe why your company requires state funding? What steps have you taken to secure other funding? How
many pitches and formal applications have you made and to whom?
Not Answered
A
Question 38: Is this a Transition Application from a Previous Bio-science or AI Proof of Concept Grant?
Yes (from Bio-Science POC grant)
Yes (from AI POC grant)
No
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Question 39: If this is a Transition Application, provide a summary of findings from the previous POC grant. Explain the
status of IP created during the POC grant & summarize the final report from POC grant.
Not Answered
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Question 40: If this is a Transition Application, upload the final investigory report from the POC project. Note please make
sure you uploaded a letter of support from the institution's TTO in the earlier question in this section.
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No Attachments
Question 41: If this is a Transition Application, please list the grant number, grant name, grant amount and grant date for
your earlier Advanced Industry or BDGEP Proof of Concept Grant.
Not Answered
Stakeholder Collaboration
Question 42: Does your company's technology and R&D apply to more than one Advanced Industry? Note if you answer
"Yes" to this question you must also select two or more AI sectors in the question in the Project Information section above
that lists the 7 AI sectors.
Yes
No
Question 43: Have you licensed technology originally developed at a research institution (university, teaching hospital,
non-profit research or medical center, private research laboratory or federal Laboratory) operating in Colorado
Yes
No
Question 44: If you answered yes to the question about licensing technology from a Colorado research institution, please
name that institution.
Not Answered
Question 45: if you answered "Yes"to the question about licensing technology from a Colorado research institution, please
explain the technology and describe the terms of the license.
Not Answered
Question 46: If you answered "Yes" to the question about licensing technology from a Colorado research institution, please
provide a letter of support for your company from the technology transfer office of the institution you licensed the
technology from.
A
No Attachments
Question 47: Has your company or its management team participated in a entrepreneurial leadership training program,
incubator, accelerator or similar program?
Yes
No
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Question 48: If you answered "Yes" to the question above please name the program, describe your current status in the
program (e.g. currently participating, completed, dropped out before completion, graduated or certified etc)?
Not Answered
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Question 49: If you have a referral letter or email from your training program, incubator or accelerator, please upload it here
in either a PDF or Word formatted file
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Question 50: Are you being referred to this program by an Angel or Venture Capital Investor Group?
Yes
No
Question 51: If you answered "Yes" to the investor referral question please provide the name of the investor doing the
referral (include both the person i.e. the Managing Director or Fund Manager and the institution or fund name)
Not Answered
Question 52: If you answered "Yes" to the investor referral question, upload a referral letter/email (PDF or Word file) from
the referring investor.
No Attachments
Strategy, Product, Technology
Question 53: Company History: Describe your business history in four sentences or less.
Not Answered
Question 54: Pitch: Provide the Company's Overall Pitch in one sentence.
Not Answered
Question 55: Product/Service Description: Provide the name and brand of your products and services and describe them in
three sentences or less.
Not Answered
Question 56: Describe the underlying technology that your product or service uses. How is this technology different from or
similar to technologies used by competitors? Provide a SWOT analysis.
Not Answered
A
Question 57: Intellectual Property: Please describe intellectual property (IP) used in your company's business model
including licensed or owned patents, trademarks, copyrights, trade secrets or other IP items. Also please describe your
overall IP Strategy.
Not Answered
Question 58: Strategy: Summarize the Company's overall business strategy in four sentences or less
Not Answered
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Question 59: Business Model: Describe how your company makes money in three sentences or less.
Not Answered
Not Answered
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Question 61: Target Market and Segment: Describe your target market and segment in two sentences or less.
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Question 60: Customer Problem: Please explain the problem you are helping solve for your customers in three sentences or
less.
Not Answered
Question 62: Customers: Does your company have an existing customer base. Describe them? Who are your early adopters?
Not Answered
Question 63: Describe your sales and marketing strategy in three sentences or less.
Not Answered
Question 64: What is your distribution and channel strategy for your product or service in three sentences or less?
Not Answered
Question 65: Competitors: Who are your company's competitors?
Not Answered
Question 66: What are your competitive advantages and weaknesses versus other market participants?
Not Answered
Question 67: Describe your company's scalability. How will its scalability impact on your likelihood of success?
Not Answered
Business Plan and Financials
Question 68: Describe the key tasks, deliverables and commercial milestones you will achieve with this grant.
Not Answered
Question 69: Upload a timeline of specific activities your company will achieve with this grant and matching funds. Please
use template timeline provided in the Resource Section.
A
No Attachments
Question 70: Explain how this grant will advance your technology and product development, moving your prototype toward
commercial launch or positions your company for further investment. How will this grant help you achieve commercial
milestones?
Not Answered
Question 71: Will your company be able to launch a new product or service at the end of this grant? Explain.
(GMS Test) Page 8 of 12
Not Answered
Question 72: If you receive the full amount of your requested grant and add in your required matching funds, will this be
enough resources to get to a defined commercial milestone? If not, specify how much additional funding you will need to
reach the milestone.
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Question 73: Regulatory Pathway: Please describe regulatory approvals and/or any key legal/regulatory regimes that will
impact your company's success. Include information about timelines, costs and your plan to work through these issues.
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Not Answered
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Question 74: Upload a detailed project budget showing how your company will use the grant & matching funds to
accomplish key commercial milestones. Please use the Company Project Budget Template provided in the Resources
Section.
No Attachments
Question 75: Upload copies of your company business plan and your investor pitch deck. Make sure the business plan
includes financial projections over at least the next 5 years both with and without receiving the funds from this grant.
No Attachments
Question 76: How much grant and third party equity capital (excluding founder's capital) has the company received since
the creation of the legal entity. This will be detailed in the Capitalization Report uploaded below.
Not Answered
Question 77: Upload a Capitalization Report documenting source, date & amount of grant & third-party cash investments
since creation of the legal entity. A grant recipient may not have received more than $20M from these sources. Do not
include founder's capital.
No Attachments
Question 78: Explain how progress achieved from this grant will increase the company's value, financial stability and better
position the company for follow-on investment. What post grant sources are you targeting for future investments (Angels,
VCs, SBIR, Other)?
Not Answered
Question 79: Specify your company's post-grant capital needs and sources, and how they relate to long-term milestones
beyond the scope of the project proposed in this grant application.
Not Answered
Question 80: Upload the following annual financial statements (in Excel file) for the company for the past 3 years and
current year to date statements: Balance Sheet, Income Statement, Statement of Cash Flows. Also include the most recent
Federal Income Tax Return.
No Attachments
A
Question 81: What are your company's projected annual revenues this year?
Not Answered
Question 82: What would be your company's projected annual revenues in the year you would complete the project funded
by the grant?
Not Answered
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Question 83: How much of the dollar growth in revenues between the previous two questions do you estimate is due to the
impact of the grant.
Not Answered
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Question 84: If your company will not have any revenue even after the project funded by the grant is completed, how much
revenue do you expect to have in your first year of commercial product launch.
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Not Answered
Company Management
Question 85: Management: Name key members of the companies management team, list their positions and compensation,
describe thier business experience and their expertise with the company's core technology.
Not Answered
Question 86: Upload CVs for key management members listed above.
No Attachments
Question 87: Has your company's founder or technology inventor published any scientific articles about your underlying
technology or have they or your company been featured in any notable press coverage? If yes please provide brief citations.
Not Answered
Question 88: List other start up companies your key management team has founded or been officers of by person. Describe
the nature of their involvement and the outcomes of those companies.
Not Answered
Question 89: Have key managers of this company ever been officers of a company that went bankrupt during their tenure
with that company? Or have any of the key managers declared personal bankruptcy? If Yes please explain.
Not Answered
Question 90: Is this company or its management currently involved in any lawsuits? If Yes please explain.
Not Answered
Question 91: List key advisers that are helping your company through strategic, financial, regulatory, technical, scientific,
engineering or legal milestones. Explain how the adviser is helping your company.
Not Answered
Question 92: If you have a signed letter or email of recommendation from one of these advisers please upload it here in
PDF file format.
A
No Attachments
Question 93: If there is any other important information the grant evaluators should consider about this company's
management please provide it here.
Not Answered
Benefits to Colorado
(GMS Test) Page 10 of 12
Question 94: How many full time equivilent (FTE) employees does your company have today in Colorado. FTE is defined
as workers being paid for 40 hours or more per week by your company.
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Question 95: How much capital in dollars has your company invested to date in Colorado? This can include capital
investments financed via contributions from the company founders, third party investors or grants.
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Not Answered
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Question 96: Explain how this grant, if awarded, will enhance the commercialization of one or more advanced industry
products or services within the State of Colorado.
Not Answered
Question 97: Exit Strategy: What is your company's exit strategy? What is the likelihood an exit will include moving
operations (including manufacturing or production) outside of Colorado?
Not Answered
Question 98: Identify the number of jobs that will be created in Colorado that will result from this grant. Answer this
question in net new FTEs (defined above and in help section) that will be created over the next three years.
Not Answered
Question 99: Identify the number of jobs that will be retained in Colorado that will result from this grant. Answer this
question in FTEs (defined above and in help section) that will be retained over the next three years.
Not Answered
Question 100: Identify the anticipated capital investment in Colorado that will result from this grant.
Not Answered
Question 101: Identify the anticipated capital retention in Colorado that will result from this grant.
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Question 102: Describe the types of employees your company expects to employee in Colorado (Headquarters
Management, Financial, Customer Services, Scientific/Technical or Engineering, Software Programmers, Sales,
Manufacturing, Other).
Not Answered
Question 103: Will this company, if successful, generate economic spillover benefits to Colorado by filling a gap in
Colorado supply chains, strengthening an ecosystem, servicing or hiring other Colorado companies or in any other way?
Please explain.
A
Not Answered
Question 104: Will your company move its headquarters or more than 50% of its employees out of Colorado if it does not
receive this grant?
Not Answered
Question 105: If you answered "Yes" to the question about moving your company out of Colorado please explain why you
would move, where you would move to and how receiving this grant would retain your company in Colorado.
(GMS Test) Page 11 of 12
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Question 106: Indentify any other projected economic impacts that will result from this grant.
Not Answered
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No Attachments
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Question 107: Upload any other files that provide information that should be considered in evaluating this grant. Make sure
the combined number of pages in any files uploaded is five or less or this material will not be considered.
(GMS Test) Page 12 of 12