Fillable RESIDENTIAL LOCK BOX PROGRAM (Golder Ranch Fire District)

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RESIDENTIAL LOCK BOX PROGRAM (Golder Ranch Fire District)

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GOLDER RANCH FIRE DISTRICT
RESIDENTIAL LOCK BOX PROGRAM
Resident’s Name: _______________________________________________________
Phone Number: _________________________________________________________
Address: ______________________________________________________________
Email: __________________________________________ Lock Box #: ____________
Special Installation Notes:
Install lockbox directly outside of the front door in plain sight. (Golder Ranch Fire
District does not install the lockboxes)
Call (520) 825-9001, ext.2102 after mounting is complete to request key installation by a
GRFD representative.
One Time Lock Box Fee of $65.00
Check #______ Cash______ Card______ Date Received__________________
By placing a key to the residence in the lock box and signing this form the resident
agrees to hold Golder Ranch Fire District harmless if the key is accessed by anyone
other than the Golder Ranch Fire District personnel and any subsequent damage or
theft results from that access. Golder Ranch Fire District personnel will only access this
key during an emergency when the resident is unable to give Golder Ranch Fire District
access to the residence or when a new key must be placed in the box.
Resident’s Signature: ____________________________________________________
GRFD Representative: ___________________________________________________
Form updated 6/24/20
FOR OFFICE USE ONLY:
Part 1 (date/time)__________________________________ Part 2 (date/time)_______________________________________
Spreadsheet Entry ____________________Accepted Payment ________________________ Deposit______________________
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RESIDENTIAL LOCK BOX PROGRAM (Golder Ranch Fire District)

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Completed 20 July 2020

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