Business Information Form - Fire Department - City of El Cerrito, California

Fire Department

Business Information Form

Developer's note: This form is not functional and requires discussion with Fire Dept personnel before they can be completed.

Date
Business Information
Business Name
E-mail
Tel
FAX
Business Address
Who is the contact person for the business?
Name
Home Phone
Home Address
Title
Business Information
	Other:

Business Lic. No.
Exp. Date:
	Same Business w/Updated Info
	New Owner/Same Business
	New Owner/New Business
Alarm System Information
	Burglar Alarm
	Fire Alarm
	Monitored by Alarm Company
Name of Alarm Company
Knox Box Key System (Key Vault)
Do you have a Knox Box	Yes No
Are the keys current	Yes No
Would you like information on our Knox Box System?	Yes No
Fire Insurance Information
Carrier
Phone
Emergency Information (For emergency use only) Provide as many names and phone numbers of persons with entry keys and alarm code information for after hours emergency.

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10890 San Pablo Avenue, El Cerrito, CA 94530-2323
Tel 510 215-4300 Fax 510 215-4319
E-Mail siarla@ci.el-cerrito.ca.us