Will the National Preparedness Guidelines Affect You? Life-Counts Can Help!

Wednesday, Nov. 19, 2008

For General Pricing for US Life Safety Products

Please complete and click "Submit"

If you haven't already taken our "QUICK REALITY QUIZ", you may like to do so before filling this form: Click Here

Please Complete All Fields
Contact Information
First Name MI Last Name Title
Street Address Suite #  
City State Zip Code Country
Phone Fax E-mail
- - - -
Building Information
Building Name Owner Management Company:
Building Type Commercial State School Private School
Building Address same as above
Street Address      
City: State Zip Code  
 
Building Stories Square Footage Building Website
Approx. # of Occupants Occupant Makeup
  • All Employees
  • Multi-tenant
  • Both
  • Teachers/Students
Please answer the following questions:
1. Do you currently have a Building Emergency Plan? Yes No
2. Have you distributed applicable parts of your building plan to all occupants? Yes No
3. Do you have an organized Emergency Response Team? Yes No
4. Do you have scheduled fire drills or building evacuations? Yes No
5. Does your municipality have life/safety codes that you must adhere? Yes No
6. If you comply with local codes, please enter the name or code # : Yes No
7. Do you maintain e-mail addresses for all building occupants? Yes No
8. If your building is multi-tenant, do you maintain e-mail addresses with all companies? Yes No
9. If your building is multi-tenant, do you maintain e-mail addresses with all company employees? Yes No
10. Does your insurance company offer discounts for life/safety programs? If you are uncertain, you should inquire. Yes No
11. If you are a non-profit 501(c)(3) organization, do you have a grant writer? Yes No
What US Life Safety products are you interested in?
Life-Counts®
If your building does not have it's own web site, would you be interested in an optional custom domain name and web site to host your Life-Counts ®? Yes No
Site-Specific Video
For Employees
For Tenants
Emergency Response Team
Building Emergency Plan
We offer discounts for simultaneous multiple-building-sign-ups. If you are interested in installing Life-Counts® in more than just the above building, please indicate:
Yes. How many additional buildings do you manage?
Comments:
How did you hear about us? 
Last updated on Monday, 07:23:57 AM (EST), September 22, 2008