Self-Certification Survey For Phase 4 Of Chicago’s Reopening

During the "Be Safe Chicago" phases of reopening, the City of Chicago wants to ensure that businesses and organizations are meeting or exceeding requirements of the "Be Safe Chicago" guidelines put in place to prevent the spread of COVID-19.

Please complete the following questionnaire to show your commitment to making Chicago as safe as possible during reopening. Please note that if your business or organization qualifies for self-certification, this does NOT exempt your business or organization from enforcement of city, state and federal laws by government departments and agencies.

If you qualify for self-certification, please post your self-certification badge in a prominent location at your place of work and on social media to show your support! #BeSafeChicago

What is the legal name of your business or organization?

What is your DBA or assumed name for your organization?

What is your business’s Integrated Revenue Information System (IRIS) account number? (Optional)

Please fill out the address information for your business or organization

Street address

Apartment, unit, building or floor number

City

State

Zip code

In which Chicago neighborhood or community area is your business or organization located?
Note: If you aren’t sure, visit this website to find your neighborhood or community area https://chicagomap.zolk.com/

Is your business or organization woman-owned?

Yes
No
No response

Is your business or organization minority-owned?

Yes
No
No response

Is your business or organization veteran-owned?

Yes
No
No response

Please enter your business or organization’s email.

Please enter your business or organization’s phone contact.

Intl code + 10 digit number

Please enter your name.

First, Last

Please describe your role within the organization.

Have you reviewed the appropriate guidelines for your industry? If your industry does not have published guidelines, have you reviewed those from comparable industries?
For more information on guidelines, please visit here