Hurricane Supply Survey Major Supply List Question Title * 1. Please enter business information as it appears on your licensing portal. Name Company Address Address 2 City/Town District ZIP/Postal Code Country Email Address Phone Number OK Question Title * 2. What items do you sell? Check all that apply. Prescription medications and glasses Food and water Water Food Battery Flashlight First aid kit Extra batteries Whistle to signal for help Dust masks Moist towelettes, garbage bags and plastic ties Wrench or pliers Manual can opener Local maps Cell phone with chargers and a backup battery Prescription medications Non-prescription medications Glasses and contact lense solution Infant formula, bottles, diapers, wipes, diaper rash cream Pet food and extra water for your pet Sleeping bags, blankets, towels Household chlorine bleach and cleaning supplies Fire extinguisher Matches, fire starters, lighters Feminine supplies and personal hygiene items Mess kits, paper cups, plates, paper towels and plastic utensils Paper and pencil Books, games, puzzles OK Question Title * 3. Please review the list below and list the per unit price of each product. List each product price by brand and quantity sold per unit. ALL WATER (SIZES & BRANDS) CEREALS (HOT AND COLD) ALL BABY FOOD BABY FORMULAS SOFT DRINKS DISPOSABLE CUPS & PLATES (ALL SIZES) DISPOSABLE SPOONS, FORKS, & KNIVES CHARCOAL PROPANE LANTERN PROPANE FUEL KEROSENE LAMPS LAMP OIL ALL BATTERIES (ALL SIZES & BRANDS) FLASHLIGHTS (ALL SIZES- PACKS & INDIVIDUAL) MATCHES (PACK & INDIVIDUAL) MEDICAL SUPPLIES & EQUIPMENT HEALTH AIDE FIRST AIDE SUPPLIES PRESCIPTION PRICES INSECTICIDES GENERATORS GAS CONTAINERS PAINTS PAINT BRUSHES, ROLLERS ETC. CONSTRUCTION SUPPLIES & MATERIALS ELECTRICAL SUPPLIES & EQUIPMENT PLUMBING SUPPLIES & EQUIPMENT ANIMAL FEED (DOG, CAT, BIRD, ETC…..) OK Question Title * 4. Please attach your pricelists for the season DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Please attach your pricelists for the season OK NEXT