Key Bridge Business Recovery Assessment Form

Assessment Form
If you are within the following communities, please fill out this Assessment Form:

Downtown and South Baltimore, Brooklyn, Brooklyn Park, Curtis Bay, Essex, Glen Burnie, Northern Pasadena, Dundalk, Turners Station and neighboring communities.
Primary Contact
Name*

First NameLast Name
Title*
E-mail*
Phone Number
Please enter a valid phone number.
Business Information
Company Name*
Business Phone Number
Please enter a valid phone number.
Website*
Business Address*

Street Address

Street Address Line 2

CityState

Zip / Postal Code
Business Type and Description*
Include core competencies and summary of your business plan
Attach Capability Statement (Optional)

Cancelof
Number of Full-time Employees
Number of Part-time Employees
Number of Minority Employees
Certifications (check all that apply)

WOSB8(a)SDVOSBVOSBHUB ZoneNone
GSA Schedule

YesNo
Specify
List your MBE Certifications.
List your Professional/Technical Certifications.
Do you or your firm have a Security Clearance?

YesNo
Specify type of clearance.
Business Structure*

CorporationPartnershipSole ProprietorshipLLCOther
Gross Annual Revenue 2022
Gross Annual Revenue 2023
Gross Annual Revenue 2024
Revenue Projection 2025
Revenue Projection 2026
Largest Contract Value
Bonding Capacity
Is your business Export Ready?

YesNo
Annual Export Sales
NAICS Codes (Top 5 only)
How was your business impacted by the Key Bridge crash?
What was your revenue in the 6 months before the crash? In the 6 months after the crash?
What is the major “pain point” for your business today?

Loss of incomeLoss of customersDifficulty in getting supplies or inventoryIncreased costs due to increased business travel for various reasonsOther
What help do you think you need to achieve better success? What does support look like to you?
What help have you received from local government or state government thus far? (State of Maryland, Baltimore City, Baltimore County, Anne Arundel County)
What assistance did you expect from each of the above, if any?
Why do you want to be in this program?
Would you like to receive news and updates from CRMSDC and the Key Bridge Business Recovery Program?

YesNoAlready on the Mailing List
Email for Newsletter
example@example.com
By choosing Yes, you are consenting to receive marketing emails from: Capital Region Minority Supplier Development Council, P.O. Box 1187, 10901 Rhode Island Ave., Beltsville, MD 20705, US, https://www.crmsdc.org
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Key Bridge Business Recovery Program
10901 Rhode Island Ave.
P.O. Box 1187
Beltsville, MD 20705

keybridge@crmsdc.org
The information collected on this form will be available to federal, state, and local agencies for use in statistical surveys and other research to track the development of minority businesses. The information entered into the form will not be available to the general public. By entering data in this form, you certify that you are authorized to make this information available to the public and agree to all terms and conditions as specified herein.
Should be Empty:

Assessment Form

Primary Contact

Business Information