Catalytic Converter Painting & Etching Program Application

Background


This is the application for local businesses to participate in the City’s Catalytic Converter Painting & Etching Program. Successful applicants will receive a $125 reimbursement from the City of Lake Forest for every vehicle serviced pursuant to the program. Please answer each question to the best of your ability. This form should take about 30 minutes or less to complete. For any questions, please contact Sharlyn De La Paz at (949) 282-5215 or [email protected]


Important Links


Catalytic Converter Theft Prevention City Webpage


Painting & Etching Program Guidelines


Painting & Etching Program Sample Agreement

* 1) Business Name
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* 2) Business Phone Number
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* 3) Business Email
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* 4) Business Address (Number & Street)
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* 5) Business Zip Code
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* 6) Business Contact Person (person filling out this form)
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* 7) Business Contact Person Title (Manager, Owner, etc.)
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* 8) Does your business provide automotive repair services at a brick-and-mortar facility located in Lake Forest?
* 9) Does your business staff technicians that are capable of painting catalytic converters with high-heat resistance paint and mechanically etching vehicle identification numbers (“VIN”) on catalytic converters with an etching machine or Dremel tool?
* 10) Which category best describes your business:
* 11) Was your business economically impacted by the COVID-19 pandemic and it’s associated economic ripple effects? These effects include the costs of complying with government mandates related to COVID-19, worker shortages (retention and recruitment), supply chain disruptions, and a decrease in sales.
* 12) Did your business experience a significant drop in retail sales over a multi-month period beginning on March 4, 2020?
If Yes to above, please describe.
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* 13) Did your business suffer hardship in recruiting and/or retaining employees as a result of COVID-19, which began on March 4, 2020?
If Yes to above, please describe.
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* 14) Did your business receive any COVID-19-related economic support (grants, loans, etc.) from any Federal, State, or local public agency? Examples include Payment Protection Program, Small Business Administration grants/loans, FEMA Disaster Recovery grants/loans, and grants or loans provided by the State of California, the County of Orange, and the City of Lake Forest.
If Yes to above, please describe.
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* 15) Did your business experience other forms of economic hardship related to COVID-19 that were not covered by the previous questions? Forms of economic hardship can include, but are not limited to: increased regulatory compliance costs and supply chain disruptions that led to sales and production issues.
If Yes to above, please describe.
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* 16) A sample agreement and program guidelines are available on the City’s website for review by applicants of this program. Have you read these documents and agree to the terms described within them?
* 17) Are you authorized to submit this form on behalf of the business you are representing?