Please note that responses to this survey will not be shared publicly. The appropriate offices will collect the data and respond individually as needed. If you have questions or concerns, you may email contact@dutchessbnn.com

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* 1. Business Name

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* 2. Corporation Type

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* 3. Business Address

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* 4. Business Contact Name

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* 5. Role (only one person per organization should answer this survey)

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* 6. Contact Phone

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* 7. Contact Email

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* 8. Industry (check all that apply)

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* 9. Primary Product or Service

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* 10. Years in Business

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* 11. Number of Full Time Employees

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* 12. Number of Part Time Employees

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* 13. Annual Gross Revenue

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* 14. Estimated COVID-19 Impact

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* 15. What form of assistance do you need now? (check all that apply)

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* 16. What will you need to get up and running? (check all that apply)

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* 17. Are you currently open for business? If yes, what are your hours?

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* 18. What services are you providing?

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* 19. How long will it take once the all clear is given to get up and running?

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* 20. What permitting or regulatory obstacles are you concerned with when reopening? (check all that apply)

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* 21. Is there a specific obstacle we can begin working on now?

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* 22. How many employees have already been laid off?

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* 23. How many employees have you furloughed?

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* 24. Do you plan to layoff or furlough additional employees?

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* 25. How many weeks of capital do you have on hand to maintain your operations?

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* 26. How are you getting information about business directives? (check all that apply)

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* 27. Do you have manufacturing capabilities and capacity to produce any essential needs such as masks, face shields, respirators, gowns, and other sanitary equipment (including hand-sanitizer and wipes)?

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* 28. Are you concerned about your Unemployment Insurance rates increasing in the long-term?

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* 29. Other thoughts/questions/recommendations

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