First Name Last Name Title

Responding For

Facility Name Infrastructure Type Agriculture and Food Banking and Finance Communications Emergency Services Energy Monument and Icons Public Works Transportation

Is There a Business Continuity Plan /Partial Plan in Place Yes No

 Is There a Vulnerability Plan /Partial plan in Place Yes No

           Is There a Vulnerability Plan /Partial Plan for

             Operations Yes No

             Facilities     Yes No

             Staff           Yes No

Please Describe The Vulnerabilities In Your Operations Or Facilities

Please Describe The Relative Resiliency For Each Of The Vulnerabilities Described Above. Describe How long It Might Take /Other Inputs That Might Be Needed To Restore Functional (not full) Operation.:

Recovery Time Frame 2 Days 4 Days 1 Week Unable To Determine depends On Event/Scale Of Event

I Believe That Our Major Vulnerabilities Are Internally Process Related Yes No

Have They Been Identified , Secured Or Duplicated Yes No

What Remains To Be Completed

What Import Or Export Depends Upon Which Infrastruture

Do You Have An Identification System To Locate/Measure Points Of Vulnerability (e.g databases e.t.c.) Yes No

Do You Regularly Survey Such Points Somewhat Frequently Frequently Very Frequently             If So How Often Somewhat Often Often Very often

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Is There Anything You Wish To Share That Has Not Been Covered In This Initial Screen

With Permision And Confidentiality, Can You Share Your Data On CI? Yes No

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