Hurricane Supply Survey

Major Supply List

Question Title

* 1. Please enter business information as it appears on your licensing portal.

Name

Company

Address

Address 2

City/Town

District

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 2. What items do you sell? Check all that apply.

Prescription medications and glasses

Food and water

Water

Food

Battery

Flashlight

First aid kit

Extra batteries

Whistle to signal for help

Dust masks

Moist towelettes, garbage bags and plastic ties

Wrench or pliers

Manual can opener

Local maps

Cell phone with chargers and a backup battery

Prescription medications

Non-prescription medications

Glasses and contact lense solution

Infant formula, bottles, diapers, wipes, diaper rash cream

Pet food and extra water for your pet

Sleeping bags, blankets, towels

Household chlorine bleach and cleaning supplies

Fire extinguisher

Matches, fire starters, lighters

Feminine supplies and personal hygiene items

Mess kits, paper cups, plates, paper towels and plastic utensils

Paper and pencil

Books, games, puzzles

Question Title

* 3. Please review the list below and list the per unit price of each product. List each product price by brand and quantity sold per unit.

ALL WATER (SIZES & BRANDS)

CEREALS (HOT AND COLD)

ALL BABY FOOD

BABY FORMULAS

SOFT DRINKS

DISPOSABLE CUPS & PLATES (ALL SIZES)

DISPOSABLE SPOONS, FORKS, & KNIVES

CHARCOAL

PROPANE LANTERN

PROPANE FUEL

KEROSENE LAMPS

LAMP OIL

ALL BATTERIES (ALL SIZES & BRANDS)

FLASHLIGHTS (ALL SIZES- PACKS & INDIVIDUAL)

MATCHES (PACK & INDIVIDUAL)

MEDICAL SUPPLIES & EQUIPMENT

HEALTH AIDE

FIRST AIDE SUPPLIES

PRESCIPTION PRICES

INSECTICIDES

GENERATORS

GAS CONTAINERS

PAINTS

PAINT BRUSHES, ROLLERS ETC.

CONSTRUCTION SUPPLIES & MATERIALS

ELECTRICAL SUPPLIES & EQUIPMENT

PLUMBING SUPPLIES & EQUIPMENT

ANIMAL FEED (DOG, CAT, BIRD, ETC…..)

Question Title

* 4. Please attach your pricelists for the season

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

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