[City of Orange] Business Survey

1. What business industry does your business fall under:

a. Retail

b. Service

c. Restaurant

d. Professional Services

e. Finance

f. Manufacturing

2. Number of Employees

a. 1 – Self Employed/Sole Proprietorship

b. 2-9 – Micro

c. 10-99 – Small

d. 100-499 – Medium

e. 500+ - Large

3. Level of impact to your business as a result of the COVID-19 Pandemic
	Significant	Moderate	Marginal	None	N/A
a. Reduction in business hours	a. Reduction in business hours/Significant	a. Reduction in business hours/Moderate	a. Reduction in business hours/Marginal	a. Reduction in business hours/None	a. Reduction in business hours/N/A
b. Staff working from home/telecommuting	b. Staff working from home/telecommuting/Significant	b. Staff working from home/telecommuting/Moderate	b. Staff working from home/telecommuting/Marginal	b. Staff working from home/telecommuting/None	b. Staff working from home/telecommuting/N/A
c. Decreased business	c. Decreased business/Significant	c. Decreased business/Moderate	c. Decreased business/Marginal	c. Decreased business/None	c. Decreased business/N/A
d. Decreased payroll	d. Decreased payroll/Significant	d. Decreased payroll/Moderate	d. Decreased payroll/Marginal	d. Decreased payroll/None	d. Decreased payroll/N/A
e. Employee furloughs/lay-off’s	e. Employee furloughs/lay-off’s/Significant	e. Employee furloughs/lay-off’s/Moderate	e. Employee furloughs/lay-off’s/Marginal	e. Employee furloughs/lay-off’s/None	e. Employee furloughs/lay-off’s/N/A
f. Financial liquidity (working capital/cash flow)	f. Financial liquidity (working capital/cash flow)/Significant	f. Financial liquidity (working capital/cash flow)/Moderate	f. Financial liquidity (working capital/cash flow)/Marginal	f. Financial liquidity (working capital/cash flow)/None	f. Financial liquidity (working capital/cash flow)/N/A
g. Operational challenges (delays in chair supply, logistics, getting goods to market)	g. Operational challenges (delays in chair supply, logistics, getting goods to market)/Significant	g. Operational challenges (delays in chair supply, logistics, getting goods to market)/Moderate	g. Operational challenges (delays in chair supply, logistics, getting goods to market)/Marginal	g. Operational challenges (delays in chair supply, logistics, getting goods to market)/None	g. Operational challenges (delays in chair supply, logistics, getting goods to market)/N/A
h. Operational pressures (cancelled contracts, access to materials)	h. Operational pressures (cancelled contracts, access to materials)/Significant	h. Operational pressures (cancelled contracts, access to materials)/Moderate	h. Operational pressures (cancelled contracts, access to materials)/Marginal	h. Operational pressures (cancelled contracts, access to materials)/None	h. Operational pressures (cancelled contracts, access to materials)/N/A
i. Forced to temporarily/permanently close	i. Forced to temporarily/permanently close/Significant	i. Forced to temporarily/permanently close/Moderate	i. Forced to temporarily/permanently close/Marginal	i. Forced to temporarily/permanently close/None	i. Forced to temporarily/permanently close/N/A

4. What are the City’s best methods to provide information about the City’s COVID-19 response? (choose 2 max)

a. Website

b. Social Media

c. Email

d. Television

e. Mailer

5. Are you interested in finding out more about the following resources?

a. City’s COVID-19 Website/Facebook

b. Payroll Protection Program (SBA)

c. Economic Injury Disaster Loan (SBA)

d. Small Business Development Center (SBDC)

e. Orange Chamber of Commerce

6. Would you like a follow-up call from the City’s Economic Development Department?

a. No

b. Yes – Provide contact information below (business name, address, telephone number, email)

7. Anything more to share?

OPTONAL** The City is gathering a list of businesses open to the public. If you would like your business added to the list, please provide the following information:

Full Name

First Name

Last Name

Address:

Address or Location