1.Are you currently facing supply chain disruptions due to the COVID-19 outbreak?

Yes

No

Uncertain

If so, what is the impact currently, and how are you responding?

2.Are you anticipating a change in your operations due to the COVID-19 outbreak, both now and for the coming months?

Yes

No

Uncertain

If so, what changes are you anticipating or planning for?

3.Is the uncertainty around the COVID-19 outbreak likely to have a financial impact on your business?

Yes

No

Uncertain

4.What information or resources do you need to help you better prepare?

5.What is your sales volume?

Under $50 Million

$50 - $99.9 Million

$100 - $499.9 Million

$500 - $999.9 Million

$1 Billion and Over

6.What is your principal product line?

Auto/Motorcycle Parts

Beverages

Chemicals

Electrical

Floor Coverings

Floral

Foodservice Equipment/Supplies

Groceries/Food

Hardware

HVAC/Refrigeration/Plumbing

Industrial

Lumber/Building Materials

Metals

Office Supplies

Paper

Petroleum

Plastics/Resins

Power Equipment

Sports Equipment

Other (please specify)

7.If you have any additional comments, please share them here: