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Section 1: BUSINESS INFORMATION
How did you hear about us?
Individual: Jane Doe DBA Jane's Bouncers, Partnership: Jane Doe & John Smith, Corporation: C Corp or S Corp, LLC: Jane's Bouncers LLC
Is this a new business?
What states do you operate in?
Where is equipment stored?
How is equipment secured?
Desired Effective Date:
Do you have an alarm?
If so, what kind?
Is the Equipment rented out with operators?
Do you use any other equipment not listed below?
Section 2: ADDITIONAL INTERESTS
Section 3: TRAILERS
Type of Trailer?
Flatbed or Cargo
Is it in a building or open area?
Is it in a fenced area?
Is there a locked gate to get into the fenced area?
How is equipment or trailers secured?
Is there a locking device on hitch or wheel?
Section 4: BUILDINGS
Home or Commercial?
Distance to nearest fire station:
Central Station alarm installed?
If yes, who is it serviced by?
Type of Central Station Alarm
Does the facility have a surveillance camera after hours?
Is the facility sprinklered?
Is there a fire alarm?
Number of fire alarms:
Please make sure that you have completed everything to the best of your knowledge before going to the next page.