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	---
ETC Phone Extension	---
Best way to reach me	---
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	---
Highest Ranking Official Phone Extension	---

Overview

Which industry best describes your organization?	Health
How many total employees do you have for all worksites?	75

Worksite #1

Business 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?	---

Applicability

Do you have 50 or more employees?

Yes

Exemptions

You may be exempt if (check all that apply)

We do not own or lease any parking spaces.

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?	---

Which transit lines stop with in 1/4 mile or 3 blocks from your worksite?

Big Blue Bus	1
Metro	Expo Rail

Which of these services and amenities are available at your worksite?

Check all that apply

Uber or Lyft Corporate Account, Locker Rooms or Showers, Bike Lockers or Secure Area

Survey Week

Survey Start Date	---
Survey End Date	---

Minimum Survey Response Rate

How many employees arrive or depart in the Morning Commute Window?	---
How many employees arrive or depart in the Evening Commute Window?	---

Average Vehicle Ridership Target

What is your AVR target?

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