State of New Jersey Business Survey

Mason Tillman Associates, Ltd. requests your assistance by completing a Business Survey. Mason Tillman has been retained by the State of New Jersey to conduct an independent evaluation of its utilization of Minority, Women, and Veteran-Owned Business Enterprises (MWVOBs) on State contracts from July 1, 2015 to June 30, 2020. This utilization will be compared to the availability of ready, willing, and able MWVOBs in the market area to determine if a statistical disparity exists. Your participation in this survey will provide valuable information that will be utilized for the Study. For additional information about the Study, contact Mason Tillman by telephone at (908) 669-9078 or by email at NJDisparityStudy@mtaltd.com.

Thank you in advance for your participation.

Business Name

First Name

Last Name

Phone

Address Line 1

Address Line 2

City

State

Postal Code

1. Indicate the ethnicity of the majority business owner:

BlackAsian AmericanAmerican Indian or Alaskan NativeHispanicCaucasian AmericanNot ApplicableOther, please specify

2. Indicate the gender of the majority business owner:

MaleFemaleNot Applicable

3. Indicate the highest level of education completed by the majority business owner:

Less than high school degreeHigh school degree or equivalent, e.g. GEDTrade/Technical certificate or degreeAssociate degreeBachelor’s degreeGraduate degreeProfessional degree

4. List any professional licenses obtained by the majority business owner:

5. Which of the following certifications does your business hold? Check all that apply.

Airport Concessions Disadvantaged Business Enterprise (ACDBE)Disabled Veteran-owned Business Enterprise (DVOB)Disadvantaged Business Enterprise (DBE)Emerging Small Business Enterprise (ESBE)LGBT-owned Business Enterprise Minority-owned Business Enterprise (MBE)Minority Woman-owned Business Enterprise (MWBE)SBA/8a/HubZoneService-disabled Veteran-owned Business (SDVOB)Small Business Enterprise (SBE)Veteran-owned Business (VOB)Woman-owned Business Enterprise (WBE)Not Applicable

6. If your business is certified, please specify the certifying agencies:

7. Indicate the industry that best describes your business:

Architectural/Engineering ServicesConstructionGoods and CommoditiesLegal ServicesProfessional ServicesOther ServicesTechnical/Trade ServicesTrucking

8. What type of goods and/or services does your business provide?

9. What year was your business established?

10. How many individuals does your business currently employ, including all full-time and part-time employees?

0-5 employees6-10 employees11-20 employees21-30 employees31-50 employeesOver 50 employees

11. Is your business bonded?

YesNoNot Applicable

11a. What is the bonding limit?

Less than $50,000$50,00 to $100,000$100,001 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 $10,000,000More than $10,000,000

12. Do you have an interest in being a prime contractor or subcontractor on a State contract?

Yes, as a prime contractorYes, as a subcontractorYes, as both a prime contractor and a subcontractorNot Applicable

13. How many bids, quotes, or proposals did your business SUBMIT to the State from July 1, 2015 to June 30, 2020?

As a prime contractor:

As a subcontractor:

14. How many State contracts was your business AWARDED from July 1, 2015 to June 30, 2020?

As a prime contractor:

As a subcontractor:

15. Would you like to participate in an interview to share your experiences contracting or attempting to contract with the State?

YesNo

16. Has your business ever implemented any of the following capacity building techniques? Check all that apply.

Joint VentureSubcontractHiring temporary or seasonal employeesHiring full-time permanent employeesNot applicableOther, please describe

17. What range best represents your business's gross revenue/sales for 2019?

Less than $50,000$50,000 to $100,000$100,001 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 $10,000,000More than $10,000,000

18. For the 2019 annual gross revenue reported above, how many individual contracts were performed?

0 Contracts

1 to 5 Contracts

6 to 10 Contracts11 to 20 ContractsMore than 20 ContractsNot Applicable

19. Approximately what percentage of your business’s total gross revenue for 2019 was derived from each of the following sources?
Round to the nearest whole number. Numbers must add up to 100%.

Public Contracts (%)

Private Contracts (%)

Other (%)

20. List the value of the three largest contracts that your business completed from July 1, 2015 to June 30, 2020:
Round to the nearest dollar.

21. Are you a member of any business or trade organizations?

YesNoNot Applicable

22. If yes, list the organizations that you are a member of: