Emission Reduction Plan 2018-2019 (Beta)

Mailing Address (All correspondence will go to this address)

Name of Recipient	---
Mailing Address (Street, Suite, City, State, Zip)	---

Employee Transportation Coordinator (ETC)

ETC Name	---
ETC Title	---
ETC Email	---
ETC Phone	---
Please upload a scanned copy of your ETC certification	---
Who provided the ETC certification?	---
Date of ETC Certification	---

Highest Ranking Official

Highest Ranking Official Name	---
Highest Ranking Official Title	---
Highest Ranking Official Email	---
Highest Ranking Official Phone	---

Secondary Contact

Name	---
Title	---
Email	---
Phone	---

Overview

Which industry best describes your organization?	Food/Bar
How many total employees do you have working in Santa Monica for all locations listed below?	67

Worksite #1

Business Name	---
DBA Name	---
Site ID	---
Address (Street, Suite, City, Zip)	---
How many employees work at this location?	---
How many of the employees working at this location live in Santa Monica?	---

Add another worksite

Would you like to add a second worksite?

No

Add another worksite

Would you like to add a third worksite?

No

Applicability

Do you have 50 or more employees?

Yes

Exemptions

You may be exempt if (check all that apply)

The entire cost of our parking spaces is included in our building lease.

Parking Details

How many parking spaces does your worksite lease?	---
What is the monthly cost per parking space leased?	---
How much, if at all, do you charge employees for parking?	---
How many employees receive cash in lieu of parking?	---