COVID-19Vaccine InformationSituation UpdatePress ReleasesCOVID-19 TestingOrders & DirectivesReopening Inyo BusinessesComm. Resiliency GrantREVIVE ProgramAttestation FormPrint MaterialsIndustry ChecklistsVideosLocal GuidanceResidentsLocal BusinessesSchoolsHospitals & ClinicsDrive-In TestingNorthern InyoSouthern InyoToiyabeMammoth HospitalTribalCity & CountyPublic LandsOther ResourcesVideo MessagesFAQsBusiness Attestation FormHomeCoronavirus (COVID-19) ResponseReopening Inyo Businesses Business Attestation Form GET CERTIFIED TO REOPEN:Review your industry guidelinesPrepare your business and complete the checklistSubmit the Inyo County Business Attestation form belowVisibly post your completed checklist within your businessBusiness NameBusiness AddressBusiness AddressFirst nameLast nameStreet addressStreet address line 2CityState- Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)CaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMicronesiaMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingZip codeMailing AddressMailing address, if differentCountry- None -United StatesEmail AddressTelephone NumberBusiness Sector- Select a value -Agriculture & Livestock (Stage 1)Animal Grooming (Stage 2)Auto Dealership (Stage 2)Campground/Outdoor Recreation (Stage 3)Car Wash (Stage 2)Casinos (Stage 3)Child Care (Stage 2)Communications Infrastructure (Stage 1)Community Center (Stage 3)Concert Venue & Live Audience Sports (Stage 4)Construction (Stage 1)Day Camps (Stage 3)Delivery Service (Stage 1)Education (Stage 3)---- Schools (Stage 3)---- Higher Education (Stage 3)Energy & Utilities (Stage 1)Entertainment Venue (Stage 3)---- Movie Theater (Stage 3)---- Gaming Facility (Stage 3)---- Pro Sports - No Audience (Stage 3)---- Indoor Museum/Gallery (Stage 3)---- Zoo (Stage 3)---- Library (Stage 3)Family Entertainment Centers (Stage 3)Film/Music/TV Production (Stage 3)Food Packing (Stage 1)Hospitality Services (Stage 3)---- Bars & Nightclubs (Stage 3)---- Wineries/Tasting Rooms/Lounges (Stage 3)Hotels and Lodging (Stage 3)Landscape Gardening (Stage 2)Life Sciences (Stage 1)Logistics and Warehousing Facilities (Stage 1)Manufacturing (Stage 2)Mining and Logging (Stage 2)Office Workspace (Stage 2)Outdoor Museum (Stage 2)Personal Care (Stage 3)---- Massage Therapy (Stage 3)---- Hair Salon (Stage 3)---- Nail Salon (Stage 3)---- Tattoo Parlor (Stage 3)---- Gyms/Fitness/Pool (Stage 3)Playground & Picnic Area (Stage 3)Public Pool (Stage 3)Public Transit (Stage 1)Real Estate Transaction (Stage 1)Religious Services (Stage 3)Restaurant (Stage 2)Retail (Stage 2)Check to Confirm Attestation1. I attest that I have implemented the State of California COVID-19 Industry Guidance in my business and filled out the COVID-19 General Checklist for my industry, if applicable.2. If my industry is not listed, I have filled out the “Limited Services” Checklist and have fulfilled all of the requirements listed in that checklist, if applicable.3. I need technical assistance to fill out the checklist applicable to my industry. If you check this box, a member of Inyo County staff will call you at the number listed above.I attest that my responses on this form are true and correctSignatureSubmit Form Preview