IMPORTANT: Attention Businesses, Non-Profit Service Providers and Self-Employed Persons. Trinity County Administration, in partnership with local stakeholders, are pulling resources together to implement a small business stabilization program to assist with financial resources in response to the shelter in place orders and the temporary closure of business operations. All information provided will be kept in strictness confidentiality and only the program review committee, consisting of three persons, will have access to it. Participation is voluntary.

Participation in this survey will have a direct impact on the disaster funding that the County of Trinity may receive for post-COVID-19 economic recovery and economic resources for the service provider community. Please be sure to state your business/organization's name clearly in the first question. This will help analysts maintain the integrity of your data.
 
The purpose of this survey is to capture current, ongoing, and cumulative data on the total amount of economic loss for businesses and service providers in Trinity County due to COVID-19. Please include your revenue sources and data with best guess year-to-date information at every survey submission, do not include forecasts. This survey is an electronic version of the Disaster Economic Impact worksheet for businesses. Please note that your information will remain confidential and not be made public. Data will only be shared with essential staff assisting the service provider community at this time.
 
We realize as this crisis progresses, you may need to update information. Please go ahead and take the survey again using the same contact information to make updates. Since this survey is designed to be taken multiple times, it is recommended by the County that you update your information on a bi-weekly basis during the COVID-19 event-be sure to use the same business name each time you repeat the survey. Thank you for your time and participation.

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* 1. What is the name of your business/organization?

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* 2. What type of services does your business/organization provide?

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* 3. Please provide the business/organization's contact information:

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* 4. When did the economic impact start for your business/organization? (your business may have suffered an economic impact prior to the shelter in place order-please give us an idea of how long your business has been impacted)

Date

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* 5. What is the estimated end date? (we do not understand how long the COVID-19 crisis will last, but economic impact may not solely be related to the shelter in place order so please provide an estimate of an end date, if anticipated)

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* 6. What were your business/organization's year-to-date revenues during the affected economic impact period (Jan 2020-through today's date)? (understanding that this period is ongoing)

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* 7. What were your business/organization's year-to-date revenues for the time period of Jan 2019-June 30, 2019?

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* 8. What is your total COVID-19 pandemic year-to-date revenue loss? (please tell us how much revenue your business/organization has lost as a result of the shelter in place order)

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* 9. What are your monthly expenses? (rent, utilities, payroll, etc.)

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* 10. What is it that your business/organization is most in need of right now?

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* 11. Amount of business interruption insurance received or anticipated, if any?

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* 12. Have you had to temporarily lay-off employees?

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* 13. Have you had to permanently lay-off employees?

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* 14. How many people did you employ prior to the COVID-19 disaster?

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* 15. How many staff do you employ now due to the COVID-19 disaster?

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* 16. Please provide a brief explanation of what adverse economic effects COVID-19 has had on your business/organization (with up-to-date information)

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* 17. Have you had to temporarily close your business/organization due to the COVID-19 disaster? (due to public safety concerns or shelter-in-place orders)

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* 18. Have you had to permanently close your business/organization's doors due to the COVID-19 disaster? (you do not anticipate re-opening after the disaster)

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* 19. What other services or support does your business/organization need at this time?

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