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Southwest Colorado Small Business Development Center

Thank you for taking the time to fill out this short survey. This information is CRITICAL to the continuation of our funding. Please help us continue to be able to offer our services by completing the short (3-minute) survey below at your earliest convenience. Estimates are fine and all information is aggregated and kept completely confidential. No individual business data is ever shared.

If you are a repeat client or long term client of SBDC and have reported impact previously, please only report on any new impact since the last time you reported.

If you have any questions or would rather report impact via telephone, please reach out to Mary Shepherd at 970-903-9311.

If you are human, leave this field blank.

Business Demographics

Name

Today’s Date

Name of Business

Phone

What is the % of female ownership?

Part A: COVID Emergency Funding Impact

If you received COVID-19 related emergency assistance funds, please complete Part A. Otherwise, if you are reporting general business impacts (business start, capital investment/financing, jobs created or retained, sales growth, and contracts), please complete Part B.

Working with and through the assistance of the Southwest SBDC, did you:

Receive an SBA EIDL Loan – What was the amount?

Receive an SBA EIDL Advanced Grant – What was the amount?

Receive a PPP Loan – What was the amount?

Receive an SBA Bridge Loan – What was the amount?

Receive a Traditional Bank Loan (other than the PPP mentioned above) What was the amount AND what type of loan was it (Commercial, Line of Credit, etc.)

Receive funds from a Private Investor – What was the amount?

Receive Other (Energize Colorado Gap Fund, La Plata Cares, Aid to All) funds – What was the amount AND from what source?

Create any new jobs with this pandemic assistance?

Yes

Number of Full Time Jobs Created

Number of Part Time Jobs Created

Were you able to retain any jobs that otherwise would have been lost, laid off or furloughed if you had not received this pandemic assistance?

Yes

Number of Full Time Jobs Retained

Number of Part Time Jobs Retained

Part B: General Business Assistance Impact

Please report all general business assistance impact here. You do not need to repeat any numbers you entered in Part A.

Working with and through the assistance of the Southwest SBDC, did you:

Start your business or purchase an existing business?

Yes

Business Start Date or Purchase Date

Business Entity Type

LLC

Sole Proprietor

Corporation

S Corporation

Partnership

501c3

Not yet in business

Create any new jobs?

Yes

If you started your business and are working there full/part time YOU are considered an employee!

Number of Full Time Jobs Created

Number of Part Time Jobs Created

Retain any jobs that otherwise would have been lost, laid off or furloughed?

Yes

If a business purchase, please include employees already working that will remain employed with you.

Number of Full Time Jobs Retained

Number of Part Time Jobs Retained

Receive any financing?

Yes

If you check yes, please identify the date, source, and amount received below.

Date of Loan

Source of financing

Commercial/Bank Loan

SBA Loan

SBA Express Bridge Loan

Private Investor

Venture Capital

Angel Investor

Other

Amount Awarded: Please identify the source and the amount received below.

If multiple sources, please include the breakdown above.

How much personal investment have you made in the business in CASH? (Do not include investment previously reported to SBDC.)

How much personal investment have you made in the business in CREDIT? (Do not include investment previously reported to SBDC.)

How much personal investment have you made in the business in ASSETS (computers, tools, vehicles, etc.)? (Do not include investment previously reported to SBDC.)

Because of the services you received from SBDC, did you increase your sales?

Yes

Amount of sales increase

What was the type of sales increase?

General Sales

Business Expansion

Export Sales

New Business

Improved Market

New Location

Franchise Sales

New Products

Business Turnaround

Did you receive HubZone Certification?

Yes

Have contracts awarded?

Federal Prime

Federal Sub

DOD Prime

DOD Sub

State Prime

State Sub

Local Prime

Local Sub

Commercial/ Private

Amount Awarded

Please identify the source and the amount received below.

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