Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Request & Agreement for Police Services

  1. Request & Agreement for the Purchase of Police Services

    • Per hour for each officer* - $50
    • Per hour for each sergeant* - $55
    • Per hour for each vehicle - $4
    *A 3-hour minimum per officer is required.

    Holidays & Special Days
    : An additional $10 per hour will be charged on the following holidays and special days:
    • Christmas Day
    • Christmas Eve
    • Easter
    • Halloween
    • Independence Day
    • Labor Day
    • Memorial Day
    • New Year’s Eve
    • Super Bowl Sunday
    • St. Patrick's Day
    • Thanksgiving Day
    • Day After Thanksgiving
    Note: 5-9 officers require 1 sergeant, 10-14 officers require 2 sergeants
  2. Applicant Information
  3. Event Information
  4. Marked patrol vehicles required:
  5. Type of Services
  6. Ongoing Service
    For ongoing service, please check which days and fill out the times requested per week.
  7. Sunday
  8. Monday
  9. Tuesday
  10. Wednesday
  11. Thursday
  12. Friday
  13. Saturday
  14. Will alcoholic beverages be served?
  15. Is this a grand opening?
  16. Certificate of occupancy provided:
  17. Is the officer required to check in upon arrival?
  18. at $50 per hour for
  19. at $55 per hour for
  20. at $4 per hour for
  21. For ongoing services only
  22. Additional Details
    Applications will be processed Monday through Friday between 8:00 am and 5:00 pm. All applications received after 5:00pm will be processed the next business day.
    A. Application should be received at least 48 hours prior to the scheduled event.
    B. Cancellation of the request must be made in writing 24 hours before the scheduled starting time, otherwise the 3-hour minimum will apply. Once an officer reports for a scheduled detail, he / she will be compensated in full, regardless of if the vendor chooses to release them before the end of the shift. Therefore, the vendor will be billed for all scheduled hours.
    C. The City of Palm Beach Gardens shall have the right to recover from the requesting organization all costs of collection of any unpaid bill, including reasonable attorney fees.
    D. Call the extra duty detail coordinator 48 hours prior to the detail to check on staffing. In the event the coordinator is unavailable, contact the Police Department directly at 561-799-4445.
    E. Payment is required by check or money order upon receipt of invoice.
    F. Out of state vendors must prepay all police services requested.
    G. No cash accepted.
    H. Send remittance to:
    City of Palm Beach Gardens
    Attention: Finance Department
    10500 North Military Trail
    Palm Beach Gardens, FL 33410
    Please include invoice number on check.

    Contact Information
    Extra Duty Details Coordinator
    Phone: 561-799-4522
    Please fax completed request to: 561-799-4408 or send an email.
  23. Billing Information
    Send bill to:
  24. May we email your invoice?
  25. Leave This Blank:

  26. This field is not part of the form submission.