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SMART Public Safety Software, Inc. 999 Home Plaza, Suite G Waterloo, IA 50701 319.433.3220 phone 1.888.834.5286 toll free 319.433.3280 fax For more information on our products and services please complete the following form. Please note that * denotes a required field Contact Information First Name* Job Title: Last Name:* Phone Number:* Agency Name:* Fax Number: Address:* Email Address:* City:* Web Site: State:* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code:* Additional Information Number of Sworn Officers: Time frame to purchase software: Please Select... 0-3 months 4-8 months 9-12 months 13-18months 18+ months Population: Do you need to utilize an RFP: Yes No Annual Calls for Service: IT staffing within your organization: Please Select ... Internal IT Staff City/County Provided 3rd Party/Contractor Dispatch Positions: Estimated Budget: Number of Jailers: Do you currently have funding? Yes No Number of Jail Beds: Are you interested in leasing hardware? Yes No Number of Mobile Units: Number of RMS Users: Products Interested in Current Vendor Install Date S*CAD S*RMS S*MOBILE S*JAIL