kernrecovers@kerncounty.com
(661) 336-6860
This form allows small businesses to request PPE, sanitation supplies, and similar items from the County at no charge.
IMPORTANT: The Kern Recovers PPE Support Program is ending on Thursday 1/28/2021 at 5:00 PM, and will not accept applications after that date/time.
The applicant must attest to the following statements by marking each of the checkboxes:
Attestation 1
Attestation 2
Attestation 3
Attestation 4
Attestation 5
Attestation 6
Attestation 7
The applicant makes the statements herein under penalty of perjury and understands that a violation of these provisions may be enforced under the law including criminal charges against the applicant and business.
Business Address
Name of Person Picking up PPE
Please select just one location for the PPE equipment to be picked up from the drop down boxes.
Select a Pickup Location Area
Please check the type or types of supplies you need. If you select gloves, please identify how many boxes of each size you need.
Available Products:
Requested Supplies
Please indicate how many boxes of each size you need. Total number of boxes must equal to 3.
Please indicate how many boxes of each size you need. Total number of boxes must equal to 6.
Please indicate how many boxes of each size you need. Total number of boxes must equal to 15.
Please indicate how many boxes of each size you need. Total number of boxes must equal to 30.
Please indicate how many boxes of each size you need. Total number of boxes must equal to 45.
Please indicate how many boxes of each size you need. Total number of boxes must equal to 60.
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Business Representative Signature
