Skip to Main Content
Loading
Loading
SUMMER HOURS
ADMINISTRATIVE OFFICES ONLY: Mon -Thu: 7:30 AM - 5:30 PM. Fri: 8 AM - 12 PM.
Read on for more information...
Search
Report an Issue
Government
Departments
Residents
Visitors
I Want To...
Home
Form Center
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
Adopt A Park
Boards & Commissions
City Assessor
City Clerk
City Manager
Community Development
Contact Information / Customer Service / Site Webmaster
Events
Finance & Purchasing
Fire Division / Police Division / Public Safety
Parks and Recreation
Portage Community Senior Center
Portager Newsletter
Public Services
Transportation & Utilities
Volunteering
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Business Emergency Information Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Steps
1.
Page 1
This section is complete
This section is incomplete
2.
Page 2
This section is complete
This section is incomplete
3.
Page 3
This section is complete
This section is incomplete
Page 1
Note
Submission of this form allows the opportunity to provide pertinent information about your business. Police personnel will input the appropriate information into their database, which will aid in rendering assistance in case of an emergency.
Date
Date
Name
Business Information
Business Type
Address
City
State
Zip Code
Phone Number
Emergency Key Holders/Contacts
Emergency Contact Number 1
First Name
Last Name
Phone Number
Address
City
State
Zip Code
Continue
Page 2
Emergency Contact Number 2
First Name
Last Name
Phone Number
Address
City
State
Zip Code
Continue
|
Go Back
Page 3
Business Owner Information
First Name
Last Name
Phone Number
Address
City
State
Zip Code
Alarm Company Information
Alarm Company Name
Phone Number
Address
City
State
Zip Code
Cleaning Company Information
Cleaning Company Name
Phone Number
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
|
Go Back
* indicates a required field
Bill Pay
City Services
Facility Rentals
Staff Directory
Meeting Agendas
Permits
Government Websites by
CivicPlus®
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow