iMerge M&A Assessement Form

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Privacy & Confidentiality Agreement *

By submitting this M&A Readiness Assessment questionnaire, you consent to iMerge Advisors, Inc. storing and processing your submitted information in compliance with applicable data protection laws, including the General Data Protection Regulation (GDPR) for European Union residents and the California Consumer Privacy Act (CCPA) for California residents. All data you provide is protected with strict security measures, including AES-256 encryption and restricted access controls, and will be kept confidential in accordance with our privacy practices. Your information will be used solely to generate your Assessment report.

Non-Disclosure Agreement

Please review the full NDA below before proceeding:

By checking and signing below, I agree to the terms of this NDA

Name *

First

Last

Email *

Phone Number *

Company Name *

Website / URL *

Year Founded *

Type of Business *

Primary Market Focus *

Number of Employees *

Revenue Model *

2022 Gross Revenues/Sales *

2023 Gross Revenues/Sales *

2024 Gross Revenues/Sales *

2025 Expected Growth Rate Vs 2024 (%) *

Enter a number ex. -5 (negative growth), or 0 (flat growth), or 10 (positive growth)

What percent of the Company's revenue is recurring? (%)

Average Gross Margin (3 years) (%) *

Average EBITDA Margin (3 years) (%) *

Is the company's recurring revenue mostly ARR or MRR billings?

Monthly Recurring Revenue (MRR) ($) *

Annual Recurring Revenue (ARR) ($)

Gross Revenue Retention (GRR) (%)

GRR measures how much revenue is retained from existing customers, excluding upsells. Enter as a percentage (e.g., 91 for 91%).

Net Revenue Retention (NRR) (%)

NRR includes upsells and cross-sells. Enter as a percentage (e.g., 110 for 110%).

Customer Lifetime Value (CLV) ($)

The total revenue expected from an average customer over their relationship with the company. Example: If your customers generate $1,500 in revenue on average, enter 1500.

Customer Acquisition Cost (CAC) ($)

The average cost to acquire a new customer. Include all marketing/sales expenses in this calculation. Enter a whole number (e.g., 1000 for $1,000).

Customer Acquisition Cost (CAC) Payback Period (Months)

The time (in months) required to recover the cost of acquiring a customer through their revenue contribution. Enter as a whole number (e.g., 9 for 9 months).

Customer Churn Rate (Monthly) (%)

Enter the percentage of customers lost each month (e.g., 10 for 10%).

Expansion Revenue Rate (%)

Percentage of revenue growth from existing customers through upsells, cross-sells, and add-ons. Enter as a whole number (e.g., 12 for 12%).

Have you received unsolicited inbound acquisition interest in the last 3 months?

Do you have a 3-year financial model with projections?

Expected 3 Yr Forecasted Growth Rate (%)

Enter as a whole number (20)

Are there key person risks (business depends on one person)?

Do you have proprietary technology or IP

IP Protection Status

Does your company fully own all code/IP

Cloud Infrastructure Type

Technology Stack Used

Technical Debt Level

Is the AI agent a "wrapper"

Which AI Tool

Do you have clear rights to use all data for training the AI Model?

Market Position & Competitive Advantage

How differentiated is your technology/service form the competitors (Scale: 1 (Not Very) - 5 (Very Much So)

Selected Value: 0

When thinking about your competitors where does the business rank in size? (0 = Last, 10 = Largest & Untouchable)

Selected Value: 0

Risks & Liabilities

Do you have any unresolved legal, compliance or regulatory issues?

Is you single largest client greater than 5% of your total revenues?

What Percentage (%) of Revenues is the Largest Client?

Enter as a whole number (20)

Capital Raise

Have you raised external capital (VC, PE, Angle)?

What type of investment have you recieved? (Select all that apply)

Friends, Family & Angel Investors
Venture Capital (VC)
Private Equity (Minority Stake)
Corporate Investment (Strategic Investors)
Crowdfunding

What Percentage of the Company do the Founders Retain? (%)

Enter as a whole number (20)

2025 restrictions delayed?

How Much Has Been Raised? ($)

Enter as a whole dollar amount (1000000)

As of the Last Raise What was the Post Valuation? ($)

Enter as whole dollar amount (1000000)

Are there any investor or board-imposed restrictions on a a potential sale?

Debt & Liabilities

Does the Company currently have any outstanding debt or loans?

Does the company have deferred liabilities (prepayments)?

Total Balance of Debt Outstanding ($)

Enter as whole number (1000000)

What type of debt financing does the Company have?

Bank Loan
Venture Debt
Revenue or Factoring Based Financing
Line of Credit (LOC)
Convertible Debt (Non SAFE Notes)
SAFE Notes
Other

Is any of the debt personally guaranteed by the founders?

Would any investor, lendor or minority shareholder need to approve an acquisition?

Would that approval be withheld or delayed?

Yes
No
Uncertain

Do customer contracts contain change of control language?

Change of control language includes (select all that apply)

Notification of a sale if a significant amount of the assets to be acquired
Notification if a stock sale
Customer must approve change of control to new acquirer
Customer has termination rights upon change of control
Price/term protection clauses triggered by acquisition

Are any debt covenents triggered upon a change of control?

Additional Feedback Comments