Sierra Madre, CA · Los Angeles County
Paramedic Subscription Program Agreement for Businesses
Businesses located in Sierra Madre use this agreement to enroll employees in the Fire Department’s paramedic subscription program and accept its coverage terms.
What this form is
This agreement enrolls a Sierra Madre business in the paramedic subscription program, which provides protection from emergency paramedic and ambulance fees for listed employees during regular business hours at the business’s fixed city location. The form requests business and subscriber details, employee enrollment numbers, and a signature. Applicants must attach a valid city business license, payroll records, and a list of employees to enroll.
Who needs it
A business physically located in Sierra Madre that wants program coverage for selected employees should complete and submit this agreement.
How to submit it
The form says payments may be made in person at City Hall or mailed to the Sierra Madre Fire Department. For additional information, contact the Fire Department by phone or email as listed on the form.
About notarization
This agreement is signed and dated without a notary; the form lists business records and an employee list as attachments, with no sworn or notarized step.
How to submit this form
- 1
Download The Agreement
Download the business paramedic subscription agreement PDF.
- 2
Complete The Form
Enter the business and subscriber information, employee enrollment count, total cost, and authorized member’s signature and date.
- 3
Gather Required Attachments
Attach a valid city business license, payroll records showing current employees, and the list of employees to enroll.
- 4
Submit With Payment
The form says payment may be made in person at City Hall or mailed to the Sierra Madre Fire Department.
Frequently asked questions
- Do I need a notary for the business paramedic subscription agreement?
- No. The agreement calls for an authorized member’s signature and date, not a notary. Attach the listed business license, payroll records, and employee enrollment list.
- Who can apply for the business paramedic subscription program?
- A business physically located within Sierra Madre may apply. Coverage is limited to enrolled employees at the business’s fixed location during regular business hours.
- What documents must I attach?
- Attach a valid Sierra Madre business license, payroll records showing current employees, and a list of employees the business wants to enroll.
- How do I submit the agreement?
- The form says payments may be made in person at City Hall or mailed to the Sierra Madre Fire Department. Contact the Fire Department using the phone number or email on the form for more information.
Need something notarized?
This Paramedic Subscription Program Agreement for Businesses doesn’t need a notary — but if you have another Sierra Madre form that does, a commissioned online notary can help.