Business Impact Survey | Tropical Storm Ida

Tropical Storm Ida Business Impact Survey

Please complete this survey if your business has been impacted by Tropical Storm Ida to be shared with the City of Elizabeth. This survey is for informational purposes only, this does NOT guarantee assistance.

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* 1. Please provide your name, property location, and phone number

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* 2. Is your property Residential or Commercial?

Residential

Commercial

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* 3. Source of Damage?

Flood

Wind

Tree/Debris

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* 4. Building affected?

Primary

Accessory

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* 5. Type of Damage?

External

Internal

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* 6. Please provide damage description

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* 7. Estimated repair costs (if known)

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* 8. Cost estimate provided by?

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* 9. Estimate time to complete?

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* 10. Has repair work been started?

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* 11. Have you applied for FEMA Aid?

Yes

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* 12. Have you received an insurance estimate?

Yes

Business Impact Survey | Tropical Storm Ida

Tropical Storm Ida Business Impact Survey

Question Title

* 1. Please provide your name, property location, and phone number

Question Title

* 2. Is your property Residential or Commercial?

Question Title

* 3. Source of Damage?

Question Title

* 4. Building affected?

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* 5. Type of Damage?

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* 6. Please provide damage description

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* 7. Estimated repair costs (if known)

Question Title

* 8. Cost estimate provided by?

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* 9. Estimate time to complete?

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* 10. Has repair work been started?

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* 11. Have you applied for FEMA Aid?

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* 12. Have you received an insurance estimate?

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* 13. Other comments/consideration