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2. Please Read

   The following information is requested annually from each of our local businesses. The information is used in the event that the Grandview Heights Police or Fire Departments need to contact someone after business hours for an emergency, such as a break-in, vandalism, or fire.

   This form is intended for official Police use only. All information submitted will be kept confidential.

4. Business Name*
6. Street Address*
8. Unit/Suite Number
10. City*
11. Zip Code*
13. What are your normal business hours?*
15. Do you have a security system?*
    -- Select One --YesNo
17. Alarm Company Name
19. Alarm Company Phone Number
21. Gate or Door Code
23. Do you have panic alarms?*
    -- Select One --YesNo
25. Do you have a Knox Box?*
    -- Select One --YesNo
27. Do you have hazardous materials onsite?*
    -- Select One --YesNo
29. After Hours Emergency Contacts
    -- Select One --YesNo

    If you have previously submitted information to the Police Department, have there been any changes?

31. Primary Contact Name*
33. Primary Contact Phone Number*
35. Secondary Contact Name*
37. Secondary Contact Phone Number*
39. Any additional information or comments?
41. Your Email Address*
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field