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Protégé Progress Report Sample

This document is for demonstration purposes only, it is not a functional web form.

MENTOR-PROTÉGÉ PROGRAM

A separate written progress report must be submitted by the mentor-protégé team for the June 30 and December 31 reporting period and conclusion of the agreement. The progress report must be electronically submitted to mentorprotege@hhs.gov.

OSDBU Tracking Number:

This report is to be completed by the PROTÉGÉ

Instructions:

The purpose of the Protégé Progress Report is to provide feedback regarding the progress of small businesses participating as Protégés in the U.S. Department of Health and Human Services' (HHS) Mentor-Protégé Program. This report also provides the Department a means of monitoring and assisting the Protégés, to enhance their developmental and technical capabilities. Finally, the information provided by the Protégés might prove helpful in making improvements to the Mentor-Protégé Program.

Protégé Company  
Name:

 

 Protégé DUNS Number

 

 Mentor Company 
Name:

 

 Agreement Start Date:

____________ (mm/dd/yyyy)

 Reporting Period

From: __________ To: ___________

 

  1. Please check the boxes below that best describe your company's small business status. (Check all that apply)

     Small Disadvantaged Business

     Women-Owned Small Business

     HUBZone Small Business

     Service-Disabled Veteran-Owned Small Business

     Veteran-Owned Small Business

  2. Please describe your company's primary areas of revenue producing functions or expertise.
  3. Please provide a brief summary of the interactions, which have taken place between your company and the Mentor, during this reporting period? Indicate the approximate amount of time for each activity, as well as the type of developmental assistance provided.

    Type of Interaction

    Duration of Interaction

    Monthly

    Weekly

    Other

    Meetings

       

    Phone calls

       

    Conferences

       

 

  1. What specific opportunities have been provided to your company as a result of this Mentor-Protégé experience?
  2. Please rate the degree to which you believe the Mentor-Protégé experience is beneficial to the growth and success of your business.

Excellent Good Fair Poor

  1. During this reporting period, has the "Deliverable/Activities," as identified in the Mentor-Protégé Agreement's "Schedule of Mentoring Activities Form," been achieved, on schedule, or in progress?
  2. Please identify and describe areas in which the Mentor is providing developmental assistance intended to expand and enhance the quality of your company's business capabilities. Check all that apply.

Business Assistance

Technical Assistance

Other

  1. Has your company received any contract/subcontract opportunities with the HHS, and other federal agencies, as a result of your company's relationship with the Mentor?
  2. Is your company growing as a result of your participation in the HHS Mentor-Protégé Program?
    If Yes, to what degree?

    Complete the area(s) below that apply:

Increase in employees: (List the number of additional employees)

Increase in revenue:   $  % (List the amount of increase in revenue and percentage of increase in profits)

Increase in profits     $  % (List the amount of increase in profit and percentage of increase in profit)

Increase in contracts   $ (List the number of additional contracts and total value [$] of additional contracts)

  1. Has your company acquired additional technical capabilities, licenses, and professional skills, as a result of the mentoring relationship?

Yes (If "Yes," please list the type.)

No 

  1. Have you received any certifications as a result of your participation in the HHS Mentor-Protégé Program?

Yes (If "Yes," please list the type of certification.)

No

  1. List the contracts/subcontracts (Non competitive and competitively) awarded by the Mentor, including the value, description of work, and period of performance.
  1. Identify other support your Mentor provided? (e.g., new equipment, use of Mentor's facilities, executive or personnel loans, finances for training requirements, etc.)
  2. Are you and your Mentor teaming (do you anticipate teaming) on federal or private sector requirements?
    If "Yes," please describe the type of teaming (i.e., prime-subcontractor) and work to be performed.

    Teaming Efforts

     Estimated Dollar Value

    Mentor Roles and Responsibilities

    Protégé Roles and Responsibilities

        
        
        
  3. If you do not believe your company has grown, since you began participation in the HHS Mentor-Protégé Program, please explain why.
  4. What changes could the HHS implement to improve the mentoring experience?

Thank you!.  Your comments will help us determine the effectiveness of this program. 


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