The Nevada City Chamber, Greater Grass Valley Chamber and Grass Valley Downtown Association are working together to source some of the necessary PPE supplies that your business needs to operate during the COVID-19 Pandemic. To get the best price points we are looking to order as much as possible at once and we need to act quickly because supplier are in high demand and there can be delays.

This is not an order form and you are not committed to purchasing anything by filling this form out. We will contact you once we have confirmed pricing with our suppliers and you can decide at that point if you would like to place an order.

Please fill out the below information no later than Friday, May 22.

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* 1. Your Email

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* 2. Face Mask Options
Please let us know if you need any of the below supplies and approximate quantities

  1-50 50-100 100+ 250+ 500+
Disposable Surgical Masks (box of 50)
Cloth Reusable Masks - (not medically certified)
Face Shields

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* 3. Will you need disposable gloves? If yes, how many will you need for the next 3 months:

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* 4. Do you need hand sanitizer? If yes, how many bottles and what sizes do you need for the next 3 months:

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* 5. Do you need infrared forehead thermometer scanners? If yes, how many:

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* 6. Do you need Hand Sanitizer Stations? If yes, how many?

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* 7. Do you need floor markers to help your guests with proper social distancing? If yes, how many packs of 3 would you need?

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* 8. Are there any other supplies you would like us to look in to sourcing for you? Please list anything you may need and quantities below:

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* 9. Your Name

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* 10. Phone Number

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* 11. Business Name 

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