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| 1a. Please indicate which of the following best describes your Business/Industry:* |
1b. Please indicate which of the following best describes your Business/Industry:* |
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| 2a. Which best describes your Title:* |
2b. Which best describes your Title:* |
| CEO, COO, Chairman, President, Owner, Principal | | Vice President - Corporate VP, Executive VP, Senior VP | | Director/Manager - General, District, Regional | | Corporate General Counsel | | Other Corporate Administrative Titles | | CFO, Vice President of Finance, Director of Finance | | Secretary, Treasurer, Controller, Comptroller | | Other Financial Titles | | VP, Director, Manager of Risk Management | | VP, Director, Manager of Employee Benefits or Human Resources/Personnel | | VP, Director, Manager of Insurance, P/C Ins. | | VP, Director, Manager of Pension or Profit Sharing, and/or Compensation | | VP, Director, Manager of Claims | | VP, Director, Manager of Health and/or Group Insurance | | VP, Director, Manager of Workers Compensation | | VP, Director, Manager of Labor and/or Industrial Relations | | VP, Director, Manager of Safety and Security | | Other Insurance Related Titles |
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| Corp Mgmnt (CEO, President, Chairman, etc) | | Corp Admin (EVP, VP, Managing Dir, Dir) | | Corp Financial (CFO) | | Other Corp Financial (Secretary, Treasurer, Controller, Comptroller) | | Insurance Agent | | Insurance Broker / Intermediary | | Consultant | | Actuary | | Attorney | | Adjuster | | Appraiser | | Accountant | | Captive Manager | | Health Care Provider | | Third-Party Administrator (TPA) | | Insurer, Underwriter | | Reinsurer | | Sales & Marketing | | Other |
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| 4. Please indicate the extent to which you are involved in the purchasing decision
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