Security/Fire Watch New Project Form

The information listed below is needed to create the service agreement and add your project to our scheduling and operations system.

Service Location Information

Name of service location *

Address

Street Address

City

State

Postal Code

Billing Information

Name of Business To Be Billed *

Has your company used American Security & Control's services within the past year? *

Yes

Has any of the billing information changed since your last service? *

Yes

How should invoices be sent? *

Postal Mail

Both

Is the billing address the same as the service location address? *

Yes

Billing Street Address

Billing State

Billing City

Billing Zip Code

Billing Contact Name *

Billing Phone Number *

Billing Email *

Are there any additional billing instructions? (PO#, Job#, special processes)

Assignment Details

Has any of the contact information changed? *

Yes

Primary Emergency Contact *

Primary Emergency Contact Phone *

Primary Emergency Contact Email *

Is the PRIMARY emergency contact the same person who will be signing the service agreement?

Yes

Name of the person signing the service agreement?

Signers Phone Number

Signers email address

Secondary Emergency Contact

Secondary Emergency Contact Phone Number

Secondary Emergency Contact Email

Does the officer need to contact anyone upon arrival

Yes

Name & phone number of person to contact upon arrival

Will the officers be given any keys/FOB keys?

Yes

How many keys will be provided and which areas require keys?

What should the officers do with the keys when service ends?

Type of Service

Fire Watch

Security

Please describe the problem you are having with your fire alarm or fire sprinkler system?

Which floors/areas are affected by the malfunctioning fire alarm or fire suppression system?

Describe what you would like the officer to do while on duty?

What is the work schedule? (Be sure to include dates, times and # of people)

Do you currently have a security company providing security guard services for your location?

Yes

Would you like us to send you information about our ongoing security guard services?

Yes

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