Business Enterprise Questionnaire-BEQ Survey Question Title * 1. Company Name Question Title * 2. Contact Name Question Title * 3. Street/Suite Question Title * 4. City Question Title * 5. State Question Title * 6. Zip Question Title * 7. Phone # Question Title * 8. Email Question Title * 9. Website Question Title * 10. Certified Entity-M/WBE/DBE/SBE Other Yes No Other (please specify) Question Title * 11. Certifying Entity Federal State City Local Private N/A Other (please specify) Question Title * 12. Section 3 Resident Yes No Question Title * 13. Owner Gender > % F M X Prefer Not to Answer N/A Question Title * 14. Owner Ethnicity > % White or Caucasian Black or African American Hispanic or Latino Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Another Race N/A Prefer Not to Answer Question Title * 15. Business Type Architectural/Engineering Services Other Services (Including consultants) Trade Partner/Subcontractor Supplier Broker/Manufacturer's Rep Manufacturer/Fabricator Trucker Other (please specify) Question Title * 16. Trade License Holder Yes No N/A to Trade Question Title * 17. Professional Service Type Question Title * 18. Standard Service Type Question Title * 19. Supplier Stocking Broker/Rep Describe Products Question Title * 20. Primary NAICS Code Question Title * 21. Primary CSI Code Question Title * 22. Union Affiliation Yes No Open Shop N/A Question Title * 23. # Full Time Emp. Question Title * 24. # Part Time Emp. Question Title * 25. % Self Performed 10% 25% 50% 75% 100% Question Title * 26. Annual $ <$100K <$500K <$1MM <$5MM <$10MM >$10MM Question Title * 27. Largest Contract <$100K <$500K <$1MM <$5MM >$5MM Question Title * 28. Average Contract $ <$100K <$500K <$1MM <$5MM >$5MM Question Title * 29. Backlog <$100K <$500K <$1MM <$5MM <$10MM >$10MM Question Title * 30. Gen'l Liability Aggregate <$1MM <$3M <$5M <$10M >$10M N/A Question Title * 31. Bonding Aggregate $750K or Less <$1MM ,$3MM <$5MM <$10M >$10M N/A Question Title * 32. EMR #(Contractors) Question Title * 33. Reference 1 Company Name Contact Name Email Address Phone Number Project Name Project Scope Your Contract Value ($) % Self-Performed Question Title * 34. Reference 2 Company Name Contact Name Email Address Phone Number Project Name Project Scope Your Contract Value ($) % Self-Performed Question Title * 35. Judgements- Last 5 years Yes No If yes, please explain Question Title * 36. Incomplete Projects Last 5 Yrs? Yes No If yes, please explain Question Title * 37. Prevailing Wage Violations Last 5 years Yes No If yes, please explain Question Title * 38. Certification Denied/Revoked Last 5 years? Yes No If yes, please explain Question Title * 39. Share Firm Details? Contract Opps Only Yes No Done