TOWN OF PARKER 
POLICE AND FIRE DEPARTMENT INFORMATION 
 
 (THIS FORM IS TO BE FILLED OUT BY ALL COMMERCIAL BUSINESSES LOCATED IN PARKER) 
BUSINESS NAME PHONE NUMBER 

BUSINESS LOCATION ADDRESS (No PO Box) CITY STATE ZIP + 4 

BUSINESS OWNER NAME HOME PHONE NUMBER  (Confidential) 

BUSINESS OWNER HOME ADDRESS (Confidential) CITY STATE ZIP + 4 

Business Information    
NORMAL OPENING TIME (Confidential) NORMAL CLOSING TIME (Confidential) EXCEPTIONS TO NORMAL TIMES 
(Confidential) 

LIST THREE PERSONS IN THE ORDER THAT YOU WANT THEM CALLED IN THE EVENT OF AN EMERGENCY: (Confidential) 
     
1) NAME TITLE ADDRESS CITY PHONE 

2) NAME TITLE ADDRESS CITY PHONE 

3) NAME TITLE ADDRESS CITY PHONE 

DO YOU HAVE AN ALARM?       Yes      No IS THE ALARM SILENT OR AUDIBLE?       Silent      Audible 
   
IS THE ALARM U/L APPROVED?       Yes      No IF SO, WHAT TYPE OF ALARM?       Burglar      Holdup      Fire 
      
NAME OF ALARM ADDRESS OF ALARM COMPANY CITY STATE ZIP PHONE 
COMPANY NUMBER 
   
Emergency Information LOCATION OF SAFE LOCATION OF LIGHTS LEFT ON LOCATION OF MAIN WATER SHUTOFF 

KNOXBOX LOCATION 
DO YOU HAVE A KNOXBOX?     Yes    No 
 
REMARKS:  (List any possible hazards to Police or Fire personnel) 

  Rev. 3.9.16