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1. Company/ Contact Information <br />First Name ❑ M ❑ F <br />Last Name <br />Company <br />Address <br />City <br />State <br />Zip <br />Phone Ext <br />( ) <br />Overview Information <br />Visit Date: <br />Parent Company Name /City /State (if applicable) <br />Interviewer <br />Name(s): <br />Organization(s): <br />2. Business Details <br />What is the primary business sector at this location? <br />❑ Administration /Support /Waste Management/ Remediation <br />Services <br />❑ Agriculture /Forestry /Fishing or Hunting <br />❑ Accommodation/ Food Services <br />❑ Arts /Entertainment /Recreation <br />❑ Construction <br />❑ Educational Services <br />❑ Finance /Insurance <br />❑ Health Care Services /Social Assistance <br />❑ Information <br />❑ Management of Companies & Enterprises <br />❑ Manufacturing <br />❑ Mining <br />❑ Professional /Scientific /Technical Services <br />❑ Real Estate /Rental and Leasing <br />❑ Retail Trade <br />❑ Transportation Warehousing <br />❑ Utilities <br />❑ Wholesale Trade <br />❑ Other: <br />Has the company's ownership or top management changed in the last year? <br />Or is change imminent? ❑ Yes ❑ No <br />If Yes, could you please explain? <br />Is this facility owned or leased? Size? ❑ Owned ❑ Leased <br />Has this company introduced new products or services during the last year? ❑ Yes ❑ No <br />If yes, could you briefly describe them? <br />Over the past year, has total company sales <br />❑ Increased ❑ Decreased ❑ Been relatively stable ❑ Fluctuated widely <br />3. Local Employment and Workforce <br />What is the total number of FTE employees at this facility? <br />Have the number of jobs at this facility changed in the last year? If so have they: <br />❑ Increased ❑ Decreased ❑ Stayed the same <br />RamseyEDA BR &E Survey; 01/31/14 <br />