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BAI performance measurement framework - May 2019

PART V. Annex

Appendix A. BAI Questionnaire

(To be completed by the BAI)

Section 1 – Organization Profile

Organization Name:

Year Established/Founded:

Primary Point of Contact
Given Name(s):
Family Name:
Email:
Phone Number:

Secondary Point of Contact
Given Name(s):
Family Name:
Email:
Phone Number:

Headquarters
Address:
City:
Province:
Postal Code:
Country:
Website:

Please select the affiliation of your organization.

Select all that apply:

What funding sources or revenue models apply to your organization?

Select all that apply:

Section 2 – Organization Program Profile

Please complete a profile for each program available at your organization.

Program:

Intake Method

Program Structure

Program Type

Select all that apply:

Target Development Stage(s)

Which best characterizes the development stage(s) of the companies that this program targets?

Select all that apply:

Target Sector(s)

Which sectors does this program target?

Select all that apply:

Program cost to client:

Select all that apply:

What type of funding is available, if any, through the program? Please select a range based on the approximate average value per recipient.

(Ranges: $1K-19K; $20K-49K; $50K-$99K; $100K-$249K; $250K+)

How is the program primarily delivered?

Indicate the annual average number of clients served by this program in a calendar year.

Appendix B. Company Questionnaire

(EXPLANATORY NOTE: Some data collection systems allow the information in Section 1 (BAI Profile) to be collected once, saved and sent back to companies in following years for review. If that is the case, the BAI administering the survey may seek to have clients simply review the company profile information annually, while still completing Section 2 (Company Growth) with updated annual data. For those using systems without this functionality, client companies should complete both Section 1 and Section 2 of the survey on an annual basis).

Section 1 – Company Profile

(To be completed once by each client company, annually reviewed, and updated as required.)

Contact Information

Business Name

Business Legal Name:
CRA Business Number:

Primary Point of Contact

Given Name(s):
Family Name:
Email:
Phone Number:

Secondary Point of Contact

Given Name(s):
Family Name:
Email:
Phone Number:

Canadian Headquarters

Street Address:
City:
Province:
Postal Code:
Website:

Profile

Is your main corporate headquarters in Canada? Y/N
Year of incorporation: YYYY
Year of first sale: YYYY
Number of establishments in Canada:
Number of establishments outside of Canada:
<Establishment – A firm can have multiple establishments or be a single establishment. An establishment is an economic unit, such as an office, a store, a farm, a mine, or a factory, that produces goods or services. It is the smallest production entity of a firm that is generally able to provide accounting information regarding the value of shipments (sales), direct costs, and labour costs.>

Stage

Which best characterizes your development stage?

Choose from:

In which industry sectors do you have active products and/or technologies (select all that apply)?

Founder Demographics

Section 2 – Company Growth
(to be completed annually)

Business Legal Name:
Is this business's company profile up to date? <If YES, proceed to survey. If NO, update company profile>

What BAI programs has your business used in the previous calendar year?
(Will match BAI Programs Profile)

What BAI programs has this business used prior to the previous calendar year?

Job Creation

In the previous calendar year, how many employees did this business have?

Full time employees (≥30 hours per week) in Canada:
Part time employees (<30 hours per week) in Canada:

Number of employees (both full and part time) outside of Canada:

Revenue

In the previous calendar year, what was this business's total annual sales revenue?

In the previous calendar year, what was the dollar value of this business's sales revenue outside of Canada (i.e. export revenue)?
<To calculate, please use your total export revenue as of December 31st of the previous calendar year. Use the Bank of Canada's Currency Converter (here) and select '1 year' for the date range.>

Capital Raised

In the previous calendar year, please indicate the amount of financing, if any, received from the relevant funding sources for your business.

Government Services

In the previous calendar year, have you received services from any federal government agencies?  If so, please specify below.

Select all that apply:

Intellectual Property

In the previous calendar year, how many active patent applications did this business have?

< Each separate jurisdiction in which a patent application has been filed counts as a separate application, e.g. separate national filings in the US and Canada count as two.>

In the previous calendar year, how many granted patents did this business have?

<Each separate jurisdiction in which a patent has been granted counts as a separate patent, e.g. granted patents from the same patent family in the US and Canada counts as two.>

Impact

Would you recommend the BAI programs to someone else (0-10 net promoter score format, 0 is low)?

Choose from:

What impact has working with the BAI programs had on this business's chance of success?

Choose from:

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