Company Name

Do you Self Perform? Do you Self Perform?YesNo

DBA

First Name

Last Name

Primary Email Address

Accounting Email Address (If different from primary email)

Compliancy Email Address (If different from primary email)

Office Number

Mobile Number

Fax Number

Website URL

Address

City

State StateALAKAZARCFCLDLDCFLGAHAIDILINIAKAKYLAMEMDMSMCMNMIMOMTNBNVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWNWVWSWY

Zip Code

Country

Have you ever worked for a National maintenance Company? Have you ever worked for a National maintenance Company?YesNo

Do you directly perform work nationwide or regionally for clients such as banks, retail stores, and restaurants? Do you directly perform work nationwide or regionally for clients such as banks, retail stores, and restaurants?YesNo

Do you specialize in residential work, commercial work, or both? Do you specialize in residential work, commercial work, or both?ResidentialCommercialBoth

Trades (Please select all that apply) Trades (Please select all that apply) Alarm Systems Appliance Repair Audio/Video Repair/Replacement Awnings Cabinetry Carpet CCTV Doors Electrical/Lighting Elevator/Escalator Fire Line & Safety Flooring Gating Glass/Board Up Handyman Janitorial/Restoration Landscaping Locks (Locksmith) Materials/Supplies Millwork Painting Pest Control Plumbing/Sewer/Drain Repair Restoration Safes Security Signage Snow Removal Upholstery Window Tinting Other

Service Area (Enter Zip codes that apply)

Do rates change by area? If yes, please explain

Hours of Operation. Are you 24/7-365?

What is your initial charge for site visits? i.e. First Hour's rate + Trip Charge (if applicable)?

What are your hourly rates?

What are your regular work hours?

What are your emergency rates?

What are your emergency hours?

If you charge a Travel Fee, what do you charge?

What is your average turn-around time by trade?

Are technicians enabled with Smart Phones? Are technicians enabled with Smart Phones?YesNo

Can technicians provide pricing from site? Can technicians provide pricing from site?YesNo

Are trucks GPS enabled? Are trucks GPS enabled?YesNo

Do you currently work with any other maintenance companies? If so, please provide references.

Additional Comments/Notes?