If you have a need to request a safety assessment of your work space, please complete
the following form and forward to Richard Bialkowski, Chief of Police/Director of Emergency Management
at firstname.lastname@example.org. Make sure the form is completely filled out prior to submitting it. Your request
will then be reviewed at the next Emergency Management Committee meeting following
receipt of your request. You will be notified of the determination of the committee
once the request has been reviewed.
Based on the results of the review and assessment, your request can be denied, approved as is, or approved with means other than those requested. *** If approved by the committee, completion of this request may be contingent upon having sufficient funds available in your budget to cover the costs of any such approved safety and security accommodation(s) and/or modification(s). ***
Click here to open/download form.