First Name *
Last Name *
Email Addresss *
Please answer all questions below. In the event a proper answer is not provided for you, select the best answer from the choices offered. 1. In two sentences, please describe the nature of your business.
2. Is your business’s industry:
In decline Staying flat Growing by 1% – 5% annually Growing by 6% – 10% annually Growing by more than 10% annually
3. How competitive are your products or services?
Our products/services are available from many other competitors. Our products/services are available from a few other competitors. Our products/services are unique in the marketplace. We have a monopoly on their products/services we provide
4. Your business holds what percentage of the market share?
Less than 1% 1% – 5% 5% – 15% 15% – 25% More than 25%
5. To what degree are you involved with your customers?
I am the main contact for all customers My employees and I collectively communicate with all customers My employees do the communication, but I make myself accessible. I have no contacts with customers
6. Which of the following best describes the level of customization you offer your customers?
We offer a complete custom solution to meet the unique needs of each customer we serve. We have a basic set of products and services and we often customize them for customers We have a standard set of products and services and we tweak them slightly for a few select customers We do not customize our products or services for individual customers
7. What percentage of your customers are VERY SATISFIED with the products/services that your company provides?
More than 95% of our customers are “very satisfied.” 80% -95% of our customers are “very satisfied.” 65% – 80% of our customers are “very satisfied.” Less than 65% of our customers are “very satisfied.”
8. How often do your existing customers refer your company to others?
Always Sometimes Rarely Never
9. In the last 24 months, what percentage of your customers made a complaint (verbal or written)?
None Less than 1% 1% – 5% 5% – 10% More than 10%
10. How do you typically get paid by your customers?
Paid 100% after the customer receives products/services. Paid an initial deposit with the balance paid after products/services are received. Paid 30-45 days after receipt of products/services. Paid 45-90 days after receipt of products/services.
11. What percentage of your overall revenue did your largest customer represent last year?
1% – 20% 21% – 35% 36% – 50% 51% – 75%
12. If you lost your largest customer, what would happen?
Huge impact that would likely kill my business Large impact, but the business would probably survive. Moderate impact, but the business would survive Minimal impact on the success of my business
13. What percentage of your yearly sales is repeat business?
None 1% – 20% 21% – 40% 41% – 75% 76% – 100%
14. How much revenue, by percentage, do you personally bring to your company?
15. Please share your company’s current position on the documentation of processes and procedures.
No need to have written documentation since it’s a small business operation. No need to have documented procedures since I, the owner, know them by heart. Summaries of our processes and procedures are documented Our processes and procedures are documented in detail.
(16-18) Please think of the person who contributes most to each of the following areas of your business. How easy or difficult would it be to replace them? For 16 and 17, if this person is yourself, please select “Cannot replace.”
16. Sales and marketing:
Very easy Easy Difficult Very difficult Cannot replace
17. Product/Service design and delivery:
18. Most significant external supplier:
Very easy Easy Difficult Very difficult Impossible
19. In the next 24 months, you expect your revenue to:
Increase by more than 30% Increase by 21% – 30% Increase by 11% – 20% Increase by up to 10% Remain at it’s current level Decrease
20. Which of the following best describes the chance of your company selling more products/services to existing customers?
Our customers are maxed out. We already sell them all the products/services they need. There are 1 – 2 additional products/services we could be selling to existing customers. There are several additional products/services we could be selling to existing customers.
21. If all customers were to triple their demand, how easily could your business ramp-up to satisfy the increased demand? Very easily Easily Difficult Very difficult Impossible
22. As a follow-up to question #21, if all customers were to triple their demand, how costly would it be to your business to satisfy the increased demand? Very costly Costly Not very costly Our costs would not be affected
23. How challenging would it be to replicate your business to serve a new geographical area? Very challenging Challenging Fairly easy Easy
24. How would your business perform if you took a leave of absence for 3 months and were unavailable? It would not be affected and would perform as it currently does. Operations would be minimally affected. Operations would suffer significantly, but the business would survive. Operations would suffer significantly and the business would probably not survive.
25. Which of the following best describes your management team? The owner is the sole manager for all operations. A few key people act as informal leaders. We have a formal management team in place.
26. Does your company have any long-term employment contracts with key individuals? Yes. Key positions have signed long-term employment contracts with key individuals. Yes. Some key positions have signed long-term employment contracts. No. Key positions are not secured by long-term employment contracts.
27. Please indicate the skill level of your employees. Employees possess minimal skills and ability. Employees possess average skills and ability. Employees possess a high level of skills and abilities.
28. Please indicate your company’s current level of employee retention. High turnover Moderate turnover Low turnover
29. By percentage of total employees, what percentage of key positions are held by family members? 61% or higher are family members 41% – 60% are family members 21% – 40% are family members 10% – 20% are family members 1% – 9% are family members None of the key position holders are family members.
30. What was your EBIDTA (Earnings Before Interest, Depreciation, Taxes & Amortization) at the end of your last fiscal year?
31. What was your company’s annual revenue (i.e. sales) IN US DOLLARS for your most recent fiscal year?
32. Business revenues (i.e. sales) for the past 3 years have shown: Good, solid growth Slow growth No growth A decline
33. What does your profitability track record indicate? Large swings in profits Moderate swings in profits Consistent profits
34. Which of the following best describes your approach to financial records? An accounting firm produces our annual statements and prepares our tax returns. We internally create our annual statements and an accounting firm prepares our tax returns. We internally create our annual statements and we file our own tax returns.
35. Please complete the following statement: “My business hires an accounting firm to annually provide us with… Reviewed statements Audited statements Both Neither
36. What is your company’s historical profit margin (gross) percentage? Gross profit is a company’s profit after selling a product/service and deducting the cost associated with its production and sale.
37. Which of the following statements best describes your cash situation? We need more cash than we generate. We regularly try to raise or borrow money. We need more cash than we generate. We occasionally try to raise or borrow money. Our business generates excess cash. We typically save this and increase our cash reserves. Our business generates excess cash. We typically invest this back into the business. Our business generates excess cash. We typically distribute this to our shareholders.
38. Under what general industry would you categorize your business?
39. What year was your company founded?
40. What year were you born?