Submit my Business & Residential Emergency Contact Information

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This information is confidential; however, in the event of an emergency we may share this information with other city departments. It is very important that this information be provided to the Police Department so that we may perform our services more efficiently should the need arise. Our goal is to keep our records accurate so that in case of an emergency, we can notify you as soon as possible. Remember, it is the responsibility of the property owner/tenant to provide accurate information and an up to date call list. Please take a few minutes to complete this form and return it to the Police Department as soon as possible. Forms can be mailed to the Ames Emergency Communications Center, 515 Clark Avenue, Ames, IA 50010, faxed to 515-239-5429, dropped off at the Police Department at any time or submitted by the form below. Please contact the Communications Center at 515-239-5133 to report any changes in information. 
Please correct the field(s) marked in red below:

1
 Business-Residential Name:
2
 Address:
3
 Telephone:
4
 Owner/Manager:
5
 Telephone:
6
 Alarm Company Servicing System:
7
 Alarm Company Telephone:
8
 Type of Alarm:
Type of Alarm:
9
If Other, please explain:
10
Any chemical hazards or explosive material on the property?
Any chemical hazards or explosive material on the property?
11
If yes, specify:
12
Is your property located in an area prone to flooding?
Is your property located in an area prone to flooding?
13
If yes, Skunk or Squaw?
If yes, Skunk or Squaw?
14
Are you responsible for any other locations?
Are you responsible for any other locations?
15
If yes, specify:
16

EMERGENCY CONTACT LIST
Please list employees who have keys for after hours access.

Names / Title / Pager-Cell Phone

EMERGENCY CONTACT LIST Please list employees who have keys for after hours access. Names / Title / Pager-Cell Phone
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