Vendor Application Form

Name of Company
Line of Business
Address 1
Address 2
City
State
ZIP Code
Phone Number
Fax Number
Salesman/Estimator Contact
Main Contact to Setup Appointments for Estimates
Customer Service Contact
Billing Contact
Years in Business
Name of Parent Company (If Applicable)
Number of Employees
Number of Service Technicians
Type of Work Performed
Typical Turnaround Time to Setup A Service Call
Emerncy Service Available?
Yes
No
Procedure In The Event of Emergency Response Required
Property Management Company 1 (Contact)
Phone
Property Management Company 2 (Contact)
Phone
Architectural/Engineering Companies/other 3 (Contact)
Phone
Architectural/Engineering Company/other 4 (Contact)
Phone
Liability Insurance Carrier
Amount of Liability Insurance
How Did You Hear of Chicago Property Services, Inc. ?
Have you faxed a copy of your insurance to our office at 312-455-0155?
Yes
No
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Yes
No