Vendor Business Economic Injury Worksheet
Please complete this form to the best of your ability and as accurately as possible regarding loss of revenue related to event cancellations due to COVID-19.
Email address *
Business Name
Your answer
Service the above business provides to festivals and events:
Your answer
Contact Info (Name, Email, Phone #)
Your answer
How many festivals or events that your business was contracted to participate in have been cancelled or postponed?
Your answer
If possible, please list the names and dates of those events below.
Your answer
With the best and most accurate number possible, what is the projected loss of revenue for your business pertaining to festival and event cancellations?
Your answer
What were your business revenues during the same time period last year?
Your answer
Did you experience loss of inventory due to these cancellations?
If yes, what is the estimated value of that loss?
Your answer
Were you eligible for insurance? If yes, what is the estimated payout?
Your answer
Directly, how many are employed by your business?
Your answer
Indirectly, (meaning participating vendors) how many were employed by your event?
Your answer
Without assistance, what is the likelihood that your event will survive or be able to continue?
Are you currently eligible for any other assistance or disaster relief? If so, please list below with amounts if known.
Your answer
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