ELIZABETH TOWNSHIP POLICE DEPARTMENT
522 ROCK RUN ROAD ELIZABETH, PA 15037
OFFICE: 412-751-7325 FAX: 412-751-7329

BUSINESS EMERGENCY CONTACT FORM

Business Name

Business Website

Business Address

Business Phone(s)

Business Fax

Business Hours

Business Email Address

Alarm Company Name

Alarm Company Phone Number

Alarm Type

External Audible

Silent/Duress

Fire

C02

Security Cameras?

Yes

If you have security cameras, they are:

Interior

Exterior

EMERGENCY CONTACTS

Name

Phone Number

Emergency Contact Address

Name

Phone Number

Emergency Contact Address

Name

Phone Number

Emergency Contact Address

Name

Phone Number

Emergency Contact Address

Name

Phone Number

Emergency Contact Address

Cleaning Company Name

Cleaning Company Phone Number

Hazardous Materials and/or Additional Information
Please provide any information on Hazardous Materials stored at your business location. You may also include any other information you believe would be helpful to the police or other emergency personnel.

**NOTE: The above information will be used for EMERGENCY PURPOSES ONLY!

The privacy of your information will be respected. The information you provide will assist officer's responding to an emergency situation at your place of business**

Thank you for submitting! Officers have received your information and will put it on file. Please resubmit the form if anything changes.

BUSINESS EMERGENCY CONTACT FORM

EMERGENCY CONTACTS

Hazardous Materials and/or Additional Information Please provide any information on Hazardous Materials stored at your business location. You may also include any other information you believe would be helpful to the police or other emergency personnel.

BUSINESS EMERGENCY CONTACT FORM

Hazardous Materials and/or Additional Information
Please provide any information on Hazardous Materials stored at your business location. You may also include any other information you believe would be helpful to the police or other emergency personnel.