Form ED-917 Annual Outcomes Questionnaire (with clients) 2020

ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Overview

OMB Approved ED-917
OMB Control Number: 0610-0098
Expires:XX/XX/XXXX
Dear EDA grantee,
The purpose of this annual questionnaire is to collect information on the outcomes attributable to program activities
sponsored under an EDA grant (or a cooperative agreement). Please report on one year of outcomes at a time (do not report
cumulatively from the start of performance under the current grant).
The first section contains questions on private investment, wages, revenue, new firm creation, and job creation and
retention outcomes as a result of the EDA grant.
The second section is broken out into the following categories of outcomes:
1. Product, Production Processes, and Business Outcomes

2.
3.
4.
5.

Markets and Business Networks Outcomes
Innovation, Technology Transfer and Commercialization Outcomes
Financing and Investment Outcomes
Human Capital and Workforce Outcomes

6.

Organizational Capacity Outcomes (includes a subsection on CEDS)

NOT all categories of questions will apply to the outcomes you expect from your project, so you will be able to bypass
any category that is not applicable to your project or skip* or select "N/A" in the cases of inapplicable questions.
For the purposes of this data collection, the word "client" can also mean "beneficiary", " firm", or "borrower". For more
information on the methodology for this questionnaire, please visit: https://www.eda.gov/performance/ or e-mail
programevaluation@eda.gov.
Agency Disclosure Notice: This information collection is authorized by OMB control #0610-0098. Public reporting burden for this collection of information is estimated
to average 6 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to U.S. Department of Commerce, (Economic Development Administration, 1401 Constitution Ave NW, Washington, DC
20230.). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection
of information if it does not display a currently valid OMB control number.

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

EDA Grant Information

* Please enter your EDA grant number:

* Total number of clients/beneficiaries/borrowers you assisted over the past year under the EDA grant:

* If applicable, what is the target industry (ies) of the scope of work under the EDA grant? (use NAICS codes where possible)
N/A
Please enter industry NAICS code(s):

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Private Investment, Revenue, New Firms, and Jobs Outcomes

For the following questions, only report on the results from the last year (not cumulative since the start of the grant) and only
enter a number (e.g., do not enter "USD", "$", "sq.ft", etc). If a question is applicable, but the outcome was not achieved, check
"No" or enter 0; if not applicable, please check "N/A"; if results are not known yet, please check "Unknown". Only the questions
with asterisks are mandatory.
* Did your clients report private investment leveraged (as a result of the assistance under the EDA grant)?
N/A
No
Unknown (but expected)
Yes (Specify total amount USD)

* Did your clients report increased operating revenue (as a result of the assistance under the EDA grant)?
N/A
No
Unknown (but expected)
Yes (Specify increase in revenue USD):

* How many new firms were created (i.e., new businesses registered) as a result of the EDA grant?
N/A
Unknown (but expected)
Number of new firms:

If applicable, please provide the NAICS codes or industry descriptions for these firms:

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If applicable, what was the average valuation of the firms you served over the past year?
N/A
Unknown (but expected)
Average valuation (USD):

How many full-time jobs were created as a result of the EDA grant (permanent, direct or directly-attributable to EDA grant)?
Please convert part-time jobs into FTEs.
N/A
Unknown (but expected)
Number of jobs created:

How many full-time jobs were retained as a result of the EDA grant (permanent, direct or directly-attributable to EDA grant)?
Please convert part-time jobs into FTEs.
N/A
Unknown (but expected)
Number of jobs retained:

If available, please provide average hourly wages (USD) or annual income for the jobs reported:
Average hourly wages
(USD)
Average annual income

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Product, Production Processes & Business Capacities

*

Were the services or assistance you provided intended to improve products, production processes and/or
business capacities?
This includes new or improved designs for products, processes or services, cost reductions or operational, environmental, or
energy efficiency improvements.
All information reported should pertain to the outcomes stemming from the project activities sponsored under an EDA
grant/cooperative agreement.

(Yes/No)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Product, Production Processes & Business Capacities

For the following questions, only report on the results from the last year (not cumulative since the start of the grant) a n d only enter a
number (e.g., do not enter "USD", "$", "sq.ft", etc). If a question is applicable, but the outcome was not achieved, check "No" or enter 0; if not
applicable, please check "N/A"; if results are not known yet, please enter or check "Unknown". Only the questions with asterisks are
mandatory.

* How many new products were launched by your clients (as a result of the assistance under the EDA grant)?
N/A
Unknown (but expected)
Number of new products:

* Did your clients report cost reductions from operational efficiencies or quality improvements (as a result of the assistance

under the EDA grant)?

(Yes/No/N/A)
* If yes, what were the total cost savings from the reported improvements?
N/A
Unknown (but expected)
Total savings reported (USD):

* Did your clients report sustainability and/or energy efficiency improvements (as a result of the assistance under the EDA

grant)?

(Yes/No/N/A)

If applicable, did the activities under the EDA grant result in improved resilience to natural or other disasters?

(Yes/No/N/A)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Markets & Business Networks

*

Were the services you provided to your clients intended to improve their access to new markets and/or
business networks?
This includes access to new customers and networks and new business strategies developed.
All information reported should pertain to the outcomes stemming from the project activities sponsored under an EDA
grant/cooperative agreement.

(Yes/No)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Markets & Business Networks

For the following questions, only report on the results from the last year (not cumulative since the start of the grant) and only enter a
number (e.g., do not enter "USD", "$", "sq.ft", etc). If a question is applicable, but the outcome was not achieved, check "No" or enter 0; if not
applicable, please check "N/A"; if results are not known yet, please enter or check "Unknown". Only the questions with asterisks are
mandatory.

* How many new customers did your clients gain (as a result of the assistance under the EDA grant)?
N/A
Unknown (but expected)
Number of new customers

* How many new professional/business partnerships were formed (as a result of assistance under the EDA grant)?
N/A
Unknown
Number of new professional/business relationships:

* Did your clients develop any of the following market strategies (as a result of the assistance under the EDA grant)?
Branding/Marketing
E-commerce
N/A
Other (please specify):

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* Did your clients develop any of the following international market strategies (as a result of the assistance under the EDA

grant)?
Export
Foreign direct investment attraction
E-commerce (international markets)
N/A
Other (e.g., global value chains entry):

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Innovation, Technology Transfer & Commercialization

*

Were the services you provided intended to assist your clients with technology transfer, commercialization,
or other innovative activities ?
This includes improvements in the Technology Readiness Level, licensing new technologies, obtaining patents, or other
government approvals.
All information reported should pertain to the outcomes stemming from the project activities sponsored under an EDA
grant/cooperative agreement.

(Yes/No)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Innovation, Technology Transfer & Commercialization

For the following questions, only report on the results from the last year (not cumulative since the start of the grant) and only enter a
number (e.g., do not enter "USD", "$", "sq.ft", etc). If a question is applicable, but the outcome was not achieved, check "No" or enter 0; if not
applicable, please check "N/A"; if results are not known yet, please enter or check "Unknown". Only the questions with asterisks are
mandatory.

* How many new technologies were licensed or brought to market (as a result of the assistance under the EDA grant)?
N/A
Unknown (but expected)
Number of newly licensed technologies

* How many new patents, trademarks, or copyrights were obtained (as a result of the assistance under the EDA grant)?

If not applicable, please enter "1" next to "N/A" field.
Patents
Trademarks (registered with
USPTO)
Copyrights
N/A

* How many new patents, trademarks, or copyrights are pending (as a result of the assistance under the EDA grant)?

If not applicable, please enter "1" next to N/A
Patents
Trademarks (registered with
USPTO)
Copyrights
N/A

Did your clients report an increase in the Technology Readiness Level (TRL) of a product or products (as a result of the
assistance under the EDA grant)? TRL assessment helps track the improvement of a technology, from basic research to scale
and operation.

(Yes/No/N/A)

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If yes, by how many TR levels did the product increase?
N/A
Unknown (but expected)
Average technology readiness level increase

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Financing & Investment

*

Were the services or assistance you provided to your clients intended to improve their access to financing
and/or investment opportunities?
This includes angel/venture deals (equity-based investments), loans, and grants (SBIR), OR any other types of external
financing that ensures the beneficiaries' financial sustainability.
All information reported should pertain to the outcomes stemming from the project activities sponsored under an EDA
grant/cooperative agreement.

(Yes/No)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Financing & Investment

For the following questions, only report on the results from the last year (not cumulative since the start of the grant) a n d only enter a
number (e.g., do not enter "USD", "$", "sq.ft", etc). If a question is applicable, but the outcome was not achieved, check "No" or enter 0; if not
applicable, please check "N/A"; if results are not known yet, please enter or check "Unknown". Only the questions with asterisks are
mandatory.

* Total number of seed stage deals made (as a result of the assistance under the EDA grant):
N/A
Unknown (but expected)
Number of seed deals:

* Total number of angel investments made (as a result of the assistance under the EDA grant):
N/A
Unknown (but expected)
Number of angel investments:

* Total number of early stage venture capital deals (Series A /B) made (as a result of the assistance under the EDA grant):
N/A
Unknown (but expected)
Number of deals:

* What were the total sums of these deals (USD)?

If not applicable, please enter "1" into the "N/A" field.
Seed Stage
Angel Investment
Venture Capital
Estimate (expected)
N/A

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* How many of the companies served over the past year experienced any of the following outcomes:

If not applicable, please enter "1" into the "N/A" field.
Acquisition
Initial Public Offering
Wind-down
Bankruptcy
N/A

* What was the number of loans, grants, or contracts (excluding from government sources) obtained by your clients/borrowers

(as a result of the assistance under the EDA grant)?
If not applicable, please enter "1" next to "N/A".
Number of loans
Number of grants
Number of contracts
N/A

* Total sum of funding secured from a non-government source(s):
N/A
Unknown (but expected)
Enter amount (USD):

* What was the number of grants, contracts, or other funding obtained from government sources (including EDA)?
N/A
Unknown (but expected)
Number of grants/contracts/other funding:

* Total sum of funding secured from a government source(s):
N/A
Unknown (but expected)
Amount (USD):

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Type of government funding secured:
Federal
State
Local
N/A

Please specify the source (e.g., SBIR) of funding obtained:

* Did EDA help you to identify federal sources of financing (e.g., loans) for your clients over the past year?

(Yes/No/N/A)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Human Capital & Workforce

*

Were the services you provided to your clients intended to help improve human capital and/or workforce?
This includes employee training or skill development, employees obtaining degrees or certificates, or new hiring activities.
All information reported should pertain to the outcomes stemming from the project activities sponsored under an EDA
grant/cooperative agreement.

(Yes/No)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Human Capital & Workforce

For the following questions, only report on the results from the last year (not cumulative since the start of the grant) and only enter a
number (e.g., do not enter "USD", "$", "sq.ft", etc). If a question is applicable, but the outcome was not achieved, check "No" or enter 0; if not
applicable, please check "N/A"; if results are not known yet, please enter or check "Unknown". Only the questions with asterisks are
mandatory.

* How many of your clients' employees/stakeholders report using new skills acquired (from activities sponsored under the EDA

grant)?
N/A
Unknown (but expected)
Number of clients using new skills

* Type(s) of new skills acquired:
Data analytics
Management/Leadership
Project management
Marketing/sales
Engineering/computer science
Finance/investment
Product development
Business analytics
Business development
Information technology
N/A
Other (please specify); if Industry-specific, please provide NAICS code (s) or descriptions.

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* How many of your clients' employees/stakeholders received licenses or certifications (as a result of the assistance under the

EDA grant)?
N/A
Unknown (but expected)
Number of clients with licenses/certifications:

* Focus of the licenses or certifications reported above: (Please check all that apply)
Management/Leadership
Business Development
Finance
Project management
Data science
Data analytics
Information technology
N/A
Other (please specify); if industry-specific, please provide NAICS code(s):

* If training or skills sessions were developed in partnership with private sector stakeholders, were any of the following

outcomes achieved:
Job placements
Increased wages for the trainees
N/A
Other (Please specify)

* Did your clients report hiring new employees, contractors, or consultants (as a result of the assistance under the EDA grant)?
Yes
No
N/A
Other (please specify)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Organizational Capacity

*

Were the services or assistance you provided to your clients intended to improve their organizational or
institutional capacity through planning, research, or other capacity-building activities?
This includes developing, updating, or implementing a Comprehensive Economic Development Strategy (CEDS) or non-CEDS
economic development plans, conducting feasibility studies, applying for and securing funding from federal and non-federal
sources to support institutional capacity and long-term strategies for regional economic resilience.
All information reported should pertain to the outcomes stemming from the project activities sponsored under an EDA
grant/cooperative agreement.

(Yes/No)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Organizational Capacity

* Over the past year, did you and/or your beneficiaries (including participating sub-jurisdictions) work on the development, update,

and/or implementation of a Comprehensive Economic Development Strategy (CEDS)?
Development
Update
Implementation
I did not work on CEDS

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Organizational Capacity

For the following questions, only report on the results from the last year (not cumulative since the start of the grant) and only enter a
number (e.g., do not enter "USD", "$", "sq.ft", etc). If a question is applicable, but the outcome was not achieved, check "No" or enter 0; if not
applicable, please check "N/A"; if results are not known yet, please enter or check "Unknown". Only the questions with asterisks are
mandatory.

* Over the past year, did your stakeholders create or finish any of the following tools to guide organizational strategy or

planning (as a result of your assistance under the EDA grant) ?
Research (economic development)
Feasibility study
Economic impact analysis (including IMPLAN ©, REMI ©, or regression analyses)
Disaster recovery, resilience, or mitigation plan
Non-CEDS economic development plan
Market study
Workforce development strategy
Productivity improvement study
A toolkit /web portal
N/A
Other (please specify)

Primary focus/goal(s) of the project(s)/tools reported above:
Foster entrepreneurship
Attract foreign direct investment
Support growth in U.S. exports
Strengthen or develop regional workforce or human capital
N/A
Other (please specify)

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* Did you assist your stakeholders in any of the following efforts to build regional economic resilience:
Broaden the industrial base with diversification initiatives (e.g., development of emerging clusters or industries)
Plan for a resilient workforce (e.g., through skills strategies in growing industries)
Conduct pre- or post-disaster recovery planning
Establish a process for regular communication, monitoring, and updating of business community needs and issues
N/A
Other (please specify)

* What other entity did you and/or your stakeholders collaborate with on economic development planning?
Local education institution
Local nonprofit organization
Regional economic development organization
Local government organization (excluding educational Institutions)
Local business organization
State government
Federal government (other than EDA)
N/A
Other (please specify)

If you had already responded to the following questions in the “Financing & Investment” section,
leave the responses below blank. If not applicable, please make sure to check "N/A". Otherwise,
please report on the outcomes from the last year.
How many of your stakeholders submitted an economic development grant or loan application(s) from a non-government
source(s) (as a result of the assistance under the EDA grant)?
N/A
Number of clients/stakeholders:

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Total sum of funding secured from a non-government source(s):
N/A
Unknown (but expected)
Enter amount (USD)

How many of your stakeholders submitted an economic development grant or loan application(s) from a government source(s)
(as a result of the assistance under the EDA grant)?
N/A
Number of clients/stakeholders:

Total sum of funding secured from a government source(s):
N/A
Unknown (but expected)
Amount (USD):

Type of government funding secured:
Federal
State
Local
N/A

Please specify which government agency(ies) (e.g., SBIR) was/were the application(s) for?

Type of projects under the secured funding:
Infrastructure (e.g., water sewer, road, rail, etc./other than buildings or facilities)
Construction or renovation of a facility (e.g., incubator)
Technical assistance
Workforce training
Planning/Research
Other (please specify)

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Did EDA help identify the resources or help to coordinate the use of other federal resources?

(Yes/No/N/A)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Organizational Capacity (CEDS)

For the following questions, only report on the results from the last year (not cumulative since the start of the grant) andonly enter a
number (e.g., do not enter "USD", "$", "sq.ft", etc). If a question is applicable, but the outcome was not achieved, check "No" or enter 0; if not
applicable, please check "N/A"; if results are not known yet, please enter or check "Unknown". Only the questions with asterisks are
mandatory.

* How did the CEDS (or the process of developing or updating the CEDS) serve as a tool to help you and/or your beneficiaries

(including participating jurisdictions) create or plan for building economic resilience in your region?
Broaden the industrial base with diversification initiatives (e.g., development of emerging clusters or industries)
Build a resilient workforce (e.g., through skills strategies in growing industries)
Conduct pre- and post-disaster economic recovery planning
Establish a process for regular communication, monitoring, and updating of business community needs and issues
N/A
Other (please specify)

Primary focus/goal(s) of the project(s) under the CEDS over the past year:
Foster entrepreneurship
Attract foreign direct investment
Support growth in U.S. exports
Strengthen or develop regional workforce or human capital
N/A
Other (please specify)

If you had already responded to the following questions in the “Financing & Investment” section,
leave the responses below blank. If not applicable, please make sure to check "N/A". Otherwise,
please report on the outcomes from the last year.
How many CEDS-aligned economic development grant or loan applications from a non-government source(s) did you and/or
your beneficiaries submit?
N/A
Number of applications:

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Total sum of funding secured from a non-government source(s):
N/A
Unknown (but expected)
Enter amount (USD):

How many CEDS-aligned economic development grant applications from a government source did you and/or your
beneficiaries submit over the past year?
N/A
Number of grant applications:

Total sum of funding secured from a government source(s):
N/A
Unknown (but expected)
Enter amount (USD):

Type of government funding secured:
Federal
State
Local
N/A

Type(s) of projects under the secured funding:
Infrastructure (e.g., water sewer, rail, road, etc./other than buildings/facilities)
Construction or renovation of a facility (e.g., incubator)
Technical assistance
Workforce training
Planning/Research
Other (please specify)

* Was the proposed CEDS-aligned project(s), coordinated with or integrated into another federally-funded planning document

(e.g., HUD Consolidated Plan, FEMA Hazard Mitigation Plan)?

(Yes/No/N/A)

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* Did EDA help identify the resources or help to coordinate the use of other federal resources?

(Yes/No/N/A)

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ED-917: Annual Capacity Outcomes Questionnaire for EDA Grantees serving clients (Noninfrastructure Programs)

Narrative Section

* Is information on the reported outcomes available at the census tract or county level? If possible, please provide the census tract

numbers or FIPS codes or Native American reservation/trust land/area names.
N/A
No
Yes (Please list counties/FIPS codes/Native lands names)

Did you or your clients use any of the following tools to plan, track and/or measure progress of the projects supported through
the scope of work under the EDA grant?
StatsAmerica: Cluster Mapping
StatsAmerica: CEDS Resource Library
StatsAmerica: the Regionizer
StatsAmerica: Innovation Index 2.0
StatsAmerica: Opportunity Zones
StatsAmerica: Measuring Distress
N/A
Other (please specify)

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Please use this section for additional comments (e.g., use this space to report on a success story resulting from the grant; if
applicable, please provide links to your annual reports where you might use the same data as reported)

What impact, if any, does the project have for distressed communities or underserved populations?

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