Soldato
The only counter for a business of that size to not be using Office 365 or an equivalent is generally that they don't want to pay for it, but usually that is because of a failure to compare like-for-like - Exchange 2007 running on an 8 year old HP Proliant on the floor in a cupboard with a half-dead storage array connected to a non-redundant network and Internet connection probably is cheaper than Office 365 licenses.
This is kind of us - except we're more up to date with exchange 2010 and the server is only 6 years old. The internet connection is however half decent with a leased line with FTTC backup.
We recently changed ISP and our new external IPs were already on a blacklist (something to check as soon as you know your IPs not as soon as it all goes wrong) and all in it took 2 WEEKS to get them removed from all lists. There are more than MXtoolbox check for example that some Government agencies use and good luck asking them to "Just white list us"...
Having said that, it's still more cost effective for us to remain on premises even though we will soon be having to shell out for a new exchange licence and CALs and new Office licences to replace Office 2010 as well (soon = within 3 years). We get our money's worth lol