COVID-19 Economic Impact Note to Respondents When you click "Done" at the end of the survey, all of your responses will be recorded. Your browser may redirect you to the blank survey. Please disregard. Thank you for your participation! OK Question Title * 1. What type of business do you operate? Agriculture, Forestry and Fishing Construction Eating and Drinking Places (Restaurants, Delis and Bars) Finance, Real Estate and Insurance Healthcare Hospitality/Tourism Manufacturing Non Profit Retail Service Industries Transportation Utilities:Electric/Gas Wholesaler Other (please specify what your business is) OK Question Title * 2. Does your business fit under any special business ownership classifications? Sole Proprietorship Women-Owned Minority-Owned Veteran-Owned Disability-Owned NA Other (please specify) OK Question Title * 3. Is your business currently operating? Yes, as normal Yes, but with reduced operations/staffing/services No, business closure (temporary) No, business closure (permanant) OK Question Title * 4. Number of full-time employees PRIOR TO COVID-19 OK Question Title * 5. Number of part-time employees PRIOR TO COVID-19? OK Question Title * 6. CURRENT total number of Full-time employees? OK Question Title * 7. CURRENT number of Part-time employees ? OK Question Title * 8. How many employees have been laid off due to COVID-19? OK Question Title * 9. How may employees have you furloughed as a result of COVID-19? OK Question Title * 10. Do you have business interruption insurance? Yes No Other (please specify) OK Question Title * 11. Have you experienced a break in your supply chain? Yes No If Yes, please describe OK Question Title * 12. Have you applied for assistance provided by your local government to offset losses due to COVID-19? No Yes If Yes, please describe what program and how much OK Question Title * 13. Have you applied for assistance provided by the CARES Act through the U.S. Small Business Administration (SBA)? Yes No OK NEXT
