* 1. Agency and Contact Information

* 2. Does your agency have any digital files of your service area and/or client location?

* 3. Please describe the geographic area your agency serves.

* 4. Which option best describes your organization?

* 5. Who is eligible for transportation services with your agency (check all that apply)?

* 6. How many Elderly (60+) Non-Disabled clients does your agency serve with transportation:

* 7. How many Elderly (60+) Disabled clients does your agency serve with transportation:

* 8. How many Non-Elderly Disabled clients does your agency serve with transportation:

* 9. How many Low Income clients does your agency serve with transportation:

* 10. How many Youth (18 and under) clients does your agency serve with transportation:

* 11. How many General Public clients does your agency serve with transportation:

* 12. What type of service does your agency provide (check all that apply)?

* 13. Does your agency provide contract transit service?

* 14. Do you contract your transportation services to a third-party?

* 15. If "Yes," what percentage is contracted out?

* 16. If "Yes," who is your contracted provider?

* 17. Does your agency coordinate with any other transit providers?

* 18. If "Yes," please list the agencies you coordinate with.

* 19. On which days of the week do you typically provide transit service (check all that apply)?

* 20. What are your typical hours of operation?

* 21. How many weeks per year do you typically provide transit service?

* 22. How many of each vehicle type do you typically operate?

* 23. What is the passenger capacity of each vehicle type you typically operate?

* 24. What is the average age of each vehicle type you typically operate?

* 25. Please provide your agency's annual passenger transportation costs for fixed-route and demand-response services. Use your agency's most current fiscal year information.

* 26. Please provide your agency's annual transportation revenues by fiscal year.

* 27. What are the major transportation needs of your agency in the next 5 years?

* 28. What are the major transportation needs of your agency in the long-term (6-20 years)?

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