The Metropolitan St. Louis Sewer District (MSD) has retained Mason Tillman Associates, Ltd. to conduct a study of the MSD's contracting practices. The MSD is committed to meeting the needs of St. Louis businesses and to ensuring equity in the award of contract opportunities. Please complete this short survey and indicate your willingness to perform MSD contracts. Thank you in advance for your participation.
For additional information, contact Mason Tillman Associates, Ltd. by telephone at (314) 754-9990, or by email at MSDStLouisDisparityStudy@mtaltd.com.
Page 2
Please complete the following information:
First Name:
Last Name:
Title:
Business Name:
Business Address:
City:
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ZIP:
Phone
Fax
Email Address:
Page 3
Please answer the questions below:
1. Indicate the Legal Structure of your business:
Please select...
S Corp
C Corp
LLC
Ltd.
Publicly Traded
Sole Proprietor
Non-Profit
Employee-Owned
Joint Venture
50/50 Partnership
2. Indicate the ethnicity of the majority owner of your business:
African American
Hispanic American
Asian Pacific American
Asian Subcontinent American
Native American
Caucasian American
Not Applicable
3. Indicate the gender of the majority owner of your business:
Male
Female
Not Applicable
4. What is the highest level of education completed by the majority owner of your business?
Less than High School Degree
High School Degree or Equivalent (e.g. GED)
Trade/Technical Certificate or Degree
Associate's Degree
Bachelor's Degree
Graduate Degree
Professional Degree
5. Please list any professional licenses obtained by the business owner.
6. Which of the following certifications does your company hold? (Check all that apply)
Minority Business Enterprise (MBE)
Woman Business Enterprise (WBE)
Small Business Enterprise (SBE)
Disadvantaged Business Enterprise (DBE)
Encouraging Diversity, Growth and Equity (EDGE)
Local Economically Disadvantaged Enterprise (LEDE)
Veteran Business Enterprise (VBE)
Not Currently Certified
Not Applicable
7. If your business is certified, please specify the certifying agencies:
8. Indicate the category that best describes your business:
Agriculture
Apparel
Banking
Biotechnology
Chemicals
Commodities/Goods
Communications
Construction
Construction Management
Construction-Related Services
Consulting
Education
Electronics
Energy
Engineering
Entertainment
Environmental
Finance
Food & Beverage
Goods and Services
Government
Healthcare
Heavy Construction
Horizontal Construction
Hospitality
Information Technology
Insurance
Legal Services
Machinery
Maintenance and Repair
Manufacturing
Media
Not for Profit
Recreation
Retail
Shipping
Technical and Trade Services
Technology
Telecommunications
Transportation
Trucking
Utilities
Vertical Construction
9. What year was your business established?
10. How many individuals does your business currently employ, including all full-time and part-time employees?
11. Is your business bonded?
Yes
No
12. If yes, please specify your total bonding limit:
13. Would you like to participate in an anecdotal interview to share your experiences contracting with or attempting to contract with the MSD?
Yes
No
Not Applicable
Page 4
14. How many bids, quotes, or proposals has your company SUBMITTED as a PRIME CONTRACTOR for the MSD's contracts from January 1, 2013, to December 31, 2017?
15. How many bids, quotes, or proposals has your company SUBMITTED as a SUBCONTRACTOR for the MSD's contracts from January 1, 2013, to December 31, 2017?
16. Do you have an interest in being a contractor on a MSD contract?
Yes
No
Not Applicable
17. Has your business utilized any of the following methods to increase your capacity to bid or perform a contract?
Joint Venture
Subcontract
Hiring Temporary or Seasonal Employees
Hiring Full-Time Permanent Employees
Not Applicable
18. What was your company's gross revenue/sales for 2017?
Less than $50,000
$50,000 to $100,000
$100,101 to $300,000
$300,001 to $500,000
$500,001 to $1,000,000
$1,000,001 to $3,000,000
$3,000,001 to $5,000,000
$5,000,001 to $10,000,000
More than $10,000,000
19. For the 2017 annual gross revenue reported above, how many individual contracts were performed as prime contracts?
1
2 to 5
6 to 10
11 to 20
More than 20
Not Applicable
20. For the 2017 annual gross revenue reported above, how many individual contracts were performed as subcontracts?
1
2 to 5
6 to 10
11 to 20
More than 20
Not Applicable
Page 5
21. List the value of the THREE largest contracts that your business completed from January 1, 2013, to December 31, 2017. Separate the value of the three contracts by a comma.
22. Are you a member of any business or trade organizations?
Yes
No
Not Applicable
23. If yes, list the organizations that you are a member of:
24. Please list the business's primary six-digit NAICS code, and any additional six-digit NAICS codes that correspond with the business's line of work. Separate NAICS codes by a comma. (For assistance looking up NAICS code, visit www.census.gov/naics)