COVID-19 BUSINESS INTERRUPTION SURVEY (April 7 , 2020) Business Profile Question Title * 1. Please provide the full legal name of your business Question Title * 2. Which of these do you consider your business to be? Service based business Product based business Question Title * 3. Please provide your business's contact information Address City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number Question Title * 4. In which of the following Counties is your business operating? Montgomery County Prince George's County Anne Arundel County Baltimore County Harford County Howard County Frederick County Carroll County Washington County Charles County Other (please specify) Question Title * 5. Do you know your NAIC code? Yes No Next