Exit COVID19 Business Impact Survey Question Title * 1. What is the current operating status of your business? Open Closed Partially Open - More than 50% Partially Open - Less than 50% Question Title * 2. If your business closed, was your decision to close due to the pandemic? Voluntary Mandatory N/A Question Title * 3. If your business closed, on what date did that occur? Date / Time Date Question Title * 4. Is your business currently operating on-site? Yes, completely No, not at all Yes, more than 50% Yes, but less than 50% Question Title * 5. Is your business currently operating remotely? Yes, completely No, not at all Yes, more than 50% Yes, but less than 50% Question Title * 6. Has your supply chain been disrupted? Yes No Question Title * 7. Have you been able to shift to providing your goods and/or services through shipping, delivery, etc? Yes, completely No, not at all Yes, more than 50% Yes, but less than 50% Question Title * 8. What is your full-time employee count? Question Title * 9. What is your part-time employee count? Question Title * 10. Has your employee count changed due to COVID-19 specifically? Yes No Question Title * 11. Since March 13, 2020, what is the number of positions hired: Question Title * 12. Since March 13, 2020, what is the number of positions working with reduced hours: Question Title * 13. Since March 13, 2020, what is the number of positions laid off: Question Title * 14. Since March 13, 2020, what is the number of positions terminated: Question Title * 15. In the next 3 months, do you anticipate any permanent reductions in your workforce? Yes No Unsure Question Title * 16. If yes, how many jobs do you anticipate eliminating? Question Title * 17. How much of your workforce is currently working remotely? All Some None Question Title * 18. If any employees are temporarily not reporting for work, what percentage are unpaid? 0 50 100 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 19. If any employees are temporarily not reporting for work, what percentage are being paid? 0 50 100 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 20. If any employees are temporarily not reporting for work and are being paid, for how many weeks will they be compensated? Question Title * 21. Is your company providing any temporary aid to unpaid employees during their furlough? If so, please describe: Question Title * 22. How would you evaluate your workforce morale today? Very Low Morale Low Morale High Morale Question Title * 23. In addition to general health, what is your greatest concern for employees during this time of emergency? Question Title * 24. Has your company’s weekly revenue experienced an increase, decrease, or no change as a result of COVID-19? Increase Decrease No Change Question Title * 25. Do you have standing lines of credit to help bridge a business interruption? Yes No Question Title * 26. How many more weeks of a business slow down or shutdown would you estimate your business could survive before closing? Question Title * 27. Have you contacted your bank about a bridge loan or other financing? Yes No Have not needed to Lenders are not responding Question Title * 28. Did your business receive federal aid? (PPP, CARES funding, EIDL, etc.) Yes No Question Title * 29. Have there been any programs at a federal level that local government could duplicate that would be helpful to your business? Question Title * 30. If federal programs have not worked for you, what type of assistance would you suggest local government could provide that would help your business continue? Question Title * 31. What are your top 3 concerns going forward? Decreasing consumer confidence/spending Financial impact on operations and/or liquidity and capital Global or US recession Impact on tax and trade issues Lack of information for decision making Lower productivity Supply chain disruptions Workforce reduction Employee Stress Other (please specify) Question Title * 32. What business supports would you find beneficial as we navigate this global challenge? Technical assistance Employee resources Information on other employer best response practices Assistance referrals Other (please specify) Question Title * 33. How do you feel about the response efforts of local (city, county) government during this time? Question Title * 34. Which one of the following best describes your organization’s primary industry? Construction Retail Trade (i.e. auto, dealers, furniture stores, hardware stores, grocery stores, pharmacies, gas stations/convenience stores, clothing stores, jewelry stores, gift stores, florists, office supplies, etc.) Finance and Insurance Professional, Scientific, and Technical Services (i.e. legal services, accounting services, architectural and engineering services, computer system design services, consulting services, etc.) Health Care and Social Assistance (i.e. doctors and dentist offices, hospitals and clinics, home health care services, nursing care facilities, family services, childcare services) Arts, Entertainment and Recreation (i.e. performing arts, sports and fitness companies and facilities, artists, writers, performers, museums, tourism and historical sites, etc.) Accommodation and Food Services (hotels, bed and breakfasts, restaurants, bars, caterers, mobile food services, etc.) Other Services (i.e. automotive repair and services, equipment repair, barber/beauty shops, funeral services, dry cleaning, churches and religious organizations, civic and social organizations, business and professional associations, and labor union organizations) Other (please specify) Question Title * 35. Please include your contact information: 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 Done