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Site Search Questionaire

Name:*
Title:*
Company:*
Address:*
City:*
State:*
Zip Code:*
Telephone:*
Fax:*
E mail*:
Web Site:
*Required Information

Company Background Information

Years in business:
Total number of employees:

Products or services produced:

SIC Codes:

Estimated annual sales: $

Tangible asset rating (please select one of below):

More than $250,000,000 More than $10,000,000
More than $100,000,000 More than $5,000,000
More than $50,000,000 More than $1,000,000
More than $25,000,000 Less than $1,000,000

What type of project are you planning?
Other:

Please list the motivating factors for this expansion/relocation (i.e., growth, workforce, incentives)

New Facility Information

Describe the particular use for the property (i.e., type of operation).

Are you interested in an existing builiding? Yes No

Are you interested in new construction cost estimates? Yes No

Estimated capital investment in facility: $

Estimated investment in equipment/machinery: $

Estimated date facility is to be operational ex: 00/00/00

Search Area

Please list below the areas in which you are interested in searching:

Facility/Site Requirements

Site acreage required:
Facility square footage:
Is there a perceived need for future expansion? Yes No
Additional square feet within years.

How does the company wish to acquire real estate?

If lease, minimum initial lease term is years, with additional option periods of years.

Rental increases to be structured:

Annually based on CPI
Fixed increases of percent each year/period
Other:

Facility Specifics

Heat
A/C
Square footage of manufacturing: Ceiling height:

Yes

No

Yes

No

Square footage of warehouse: Ceiling height:

Yes

No

Yes

No

Square footage of office: Ceiling height:

Yes

No

Yes

No

Bay size or column spacing:

Airport access? Yes No
Within: Other:

Rail Service? Yes No

Rail spur nearby? Yes No

Rail service door? Yes No

Truck door? Yes No
Number of doors:

Drive-in door? Yes No
Number of doors:

Sprinklers? Yes No
Wet Dry

Number of cranes? Ton size:

Special lighting? Yes No
Describe:

Special ventilation? Yes No
Describe:

Special HV/AC? Yes No
Describe:

Special floors? Yes No
Describe:

Addtional Specifications:

Facility Operations

Number of shifts per day

Number of days per week

Number of weeks per year

Utilities

Are you interested in utility costs for the proposed facility? Yes No

If yes, under separate cover please enclose last year's bills on a similar plant for the utility(ies) of interest: water, sewer, gas/oil, electricity and waste disposal.

Water Well Main Either Usage
Gallons per day
Days per month
Sewer Septic Main Either Usage
Gallons per day
Days per month
Gas Yes
No
Usage - Therms per month
Seasonal usage
Yes No
Peak demand time day/week/month
Electric Volts
Amps Three phase Yes No
Demand

KW
Consumption

KWH
Load Factor
%
Peak demand time day/week/month

Labor Information

Estimate number and types of jobs that will be created within the first five years at the proposed facility. Please be as specific as possible.

Job Title Number Average
Hourly Wage
Special skills required
Total # of facility employees
Total # of new jobs
Overall hourly wage
($/hr)

Incentives

Please check if you have an interest in the following economic incentives:

Incentive Yes No
Free employee training
Tax abatement
Tax credits
Facility loans
Equipment loans
Free or reduced-cost site
Free employee screening
Enterprise zones

Feedback is critical to our mutual success. As a recipient of this service, your company's primary obligation is to respond to monthly requests for brief project updates.

I understand this obligation and will respond to the SSN's information request in a timely manner.

I have read the SSN Client License Agreement (see above)

This is a mandatory requirement. Process will be suspended if box is not checked. Thank you.


Site Selection Network • 25108 Marguerite Parkway, B-204, Mission Viejo, CA 92692
Telephone: (949) 472-4482 • Fax: (949) 472-5494 • E-mail: jrenzas@locationmgmt.com • Web site: http://www.siteselectionnetwork.com