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2. Waunakee Police and Fire Business Contact Form
3. Date/Time:
   Date/Time:

   Date/Time:
5. Business/Organization Name: *
7. Street Address*
9. Mailing Address:*
10. City:*
11. Zip Code:*
13. Business Phone:*
14. Business Email:*
16. PERSONS TO CONTACT IN CASE OF EMERGENCY
18. #1 Name:*
19. Phone #*
20. Cell #*
22. #2 Name*
23. Phone #*
24. Cell #*
26. #3 Name:
27. Phone #
28. Cell #
30. #4 Name
31. Phone #
32. Cell #
34. Alarm Systems*

    1. Yes
    2. No
    3. If Yes, Silent
    4. Audible
36. Type of alarm(s):

    1. Burglar
    2. Fire
    3. Hold-Up
    4. Panic
    5. Motion
    6. Other
38. Surveillance Cameras

    1. Yes
    2. No
40. Name of alarm company:
42. 24 hour telephone number for the alarm company:
44. Panel Location:
46. Are there firearms in the building?

    1. Yes
    2. No
47. If so, where?
49. Are there animals in the building?

    1. Yes
    2. No
50. If so, kinds/locations?
52. Are there interior security lights?

    1. Yes
    2. No
54. Are there exterior security lights?

    1. Yes
    2. No
56. Heating type:
57. Location:
59. Gas shut off:
60. Electric shut off:
62. Sprinklers

    1. Yes
    2. No
64. Standpipes

    1. Yes
    2. No
66. Hazardous materials (list types and locations):
68. Normal business hours:
70. Other special instructions:
72. Branch or corporate security contact name:
73. Phone #
75. Do cleaning or maintenance personnel have after hours access to the building?

    1. Yes
    2. No
77. If yes, what time does cleaning occur?
79. List cleaning personnel names:
81. Main Shut Off:
82. Size:
Leave This Blank:


84. 1. Receive an email copy of this form.
85. Email address

    This field is not part of the form submission.

86. Submit Submit and Print

* indicates a required field