Is the Host Country of the project Georgia?

Yes

No     please specify:

Please indicate the percentage of government ownership in the project:

%

Please indicate the percentage of US ownership in the project:

%

Can the project sponsors demonstrate a successful, 3-year track record in the designated line of business?

Yes

No

Have the sponsors demonstrated experience in and knowledge of the host country, market and environment?

Yes

No

In what sector does the business operate?

Administrative and Support Arts Entertainment and Recreation Agriculture Construction Educational Services Energy Finance and Insurance Health Care and Social Assistance Information Services-Publishing and Telecommunications Management of Companies Manufacturing Mining-Quarrying-Oil and Gas Extraction Professional Scientific and Technical Services Public Administration Real Estate-Rental-Leasing Retail Trading Transportation and Warehousing Utilities Waste Management and Remadiation Services Wholesale Trade Other Services     please specify:

Does the project involve any of the following business activities?

Please indicate if the project is a new venture (start-up project) or expansion of an existing business:

New venture/start-up

Existing business/project

What is the estimated total project cost?

USD

What is the amount sought in terms of debt financing from an IFI?

USD

Please indicate other sources of financing (debt or equity) of the project: (Check all that apply)

Debt/Loan      USD

Equity      USD

Type of Collateral:

Cash

Marketable Assets (85% of receivables, 50% of inventory)

Perfected Senior Liens on Fixed Assets

Pledge of Shares

Assignment of Contracts

Concessions or licenses

Escrow and other accounts

Other (Indicate)     

Will the collateral value cover 100 % of the loan amount?

Yes

No

Could the project have a negative impact on the environment, specifically, does the project involve a dam, ozone depleting substances, and persistent organic pollutants; or could it effect any natural habitat, wilderness or wildlife reserve?

Yes

No

Would the project require the resettlement of anyone?

Yes

No

Does the project involve termination of any US operations?

Yes

No

Does the project violate local labor laws?

Yes

No

Please provide the project details briefly (What does the project seek to accomplish? State the key elements of the project – specific assets needed; current market for the product(s) or service(s) involved; size of the market and expected growth; projected revenues, anticipated cash flow and profitability of the project):

Are there any documentations available for review?

Business plan

Financial model/projections

Audited financial statements

Marketing plan

Environmental impact assessment report

Feasibility study

Building/facility drawings, construction scheduling and costs

None of the above

Contact Information:

Security Code: