Oil Price & COVID-19 Business Impact Question Title * 1. What is your current operating status? Operating facility at ___% capacity Operating remotely at ___% capacity Voluntary closure until ________ Forced closure until ________ OK Question Title * 2. What is your current total employee count? Full time ___ Part time ___ OK Question Title * 3. Has your employee count changed due to COVID-19? Yes No Other (please specify) OK Question Title * 4. Has your employee count changed due to Oil/Economy downturn? Yes No Other (please specify) OK Question Title * 5. Please estimate your company’s weekly/monthly revenue change experienced as a result of COVID-19: Increase (% change) Decrease (% change) Other (please specify) OK Question Title * 6. Please estimate your company’s weekly/monthly revenue change experienced as a result of Oil/Economy downturn: Increase (% change) Decrease (% change) Other (please specify) OK Question Title * 7. How many weeks of business slow down or shutdown would you estimate your business could survive before closing permanently? weeks Other (please specify) OK Question Title * 8. Do you have standing lines of credit established to help bridge business interruption? If yes, is it adequate? Yes No Other (please specify) OK Question Title * 9. Have you contacted your financial institution about a bridge loan or other financing? Yes No Other (please specify) OK Question Title * 10. Do you anticipate any permanent reductions in your workforce? Next 3 months? Next 6 months? OK Question Title * 11. Are you interested in an SBA Economic Injury Disaster Loan or other Federal programs when they become available? Yes (requires contact info for follow up) No Other (please specify) OK Question Title * 12. Which of the following best describes your organization’s primary industry? Accommodation, Hospitality & Food Services Administrative Support, Waste Management, & Remedial Services Agriculture, Forestry, Fishing and Hunting (farming, crop production, animal production, fishing, etc.) Arts, Entertainment, Recreation Educational Services Finance & Insurance Healthcare & Social Services Information Management of Companies & Enterprises Manufacturing Mining, Quarrying, and Oil and Gas Extraction Non-profit Other Services Professional, Scientific, & Technical Services Public Administration Real Estate, Rental, & Recreation Retail Trade Transportation & Warehousing Utilities Wholesale Trade Not sure Other (please specify) OK Question Title * 13. Other areas of concern... OK Question Title * 14. Respondent Information | All responses will be held in confidence Name Company Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Email Address Phone Number OK SUBMIT