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Vendor Application
Company
Attn:
Mailing Address:
Email Address:
Phone:
Fax:
After Hour/Weekend Requests Phone:
Primary Contact:
Primary Contact Email:
Alt Contact Name:
Alt Contact Email:
Alt Contact Phone:
A/R Contact Name:
A/R Contact Phone:
A/R Contact Email:
Can you receive, update, and invoice work orders via the internet?
Yes
No
Minority Business Certification (check all that applies and provide corresponding certificates)
MBE
WBE
MBE/WBE
Veteran
Disabled Veteran
Cleaning Services Provided: (Check all that apply)
Commercial Cleaning(includes floors, restrooms)
Disinfecting/Sanitizing
Restroom Deep Cleaning
Please list all other services your company provides:
Number of Technicians:
Uniform (shirt minimum)
Yes
No
Photo ID
Yes
No
Age of company
Construction %
Service%
Do you use subcontractors?
Self-Perform %
Subcontracted %
Do you provide 24 hr. service, seven days a week?
Yes
No
Service Territory: (attach separate sheet if necessary)
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