Your Name and title:
Business Name:
DBA:
Date Established Federal Employer No.
Phone No. Fax No.
E-Mail Address:
Physical Address (Street, Suite No.):
City State Zip Code:
Annual Sales Volume: $
Business Form:
Corporation LLC Limited Partnership
General Partnership Sole Ownership
Subsidiary of Division of
Parent Company:
Address:
Names and Address of Officers and/or Owners:
President:
Email address
Vice-President:
Email address
List any branch Offices
List any licenses, certifications or special training:
What is your Service Area? (We are trying to limit overlap between Authorized Dealers, so please be specific, give a mile radius around your home office along with various states/cities etc you service.)
Please tell us about your experience:
How long has your company been servicing Self Storage?
How many technicians or installers do you employ on a regular basis?
Customer References:
Please provide your information on the three most recent installation or repair jobs.
Customer City State Equipment/Job type No of units
Does your company have a specialty?
If yes, what is it?
Product Information:
Do you wish to receive advanced notice of upcoming products or
product enhancements? Yes No
What is your preferred method of contact? Phone Fax Email
Do you have any product enhancement suggestions?
If yes, please explain.
Are there any products that you would like to be made available?
If yes, please explain.
Which brands of access control and alarm equipment do you install?
What kind of equipment is it?
Which of these do you provide, install or service:
Perimiter Beam Installation
Perimiter Beam Service
Video Surveillance Systems
Access Control Installations
Access Control Service
Alarm System - Commercial
Alarm System - Mux or Single Unit
Install or Service CCTV
Install or Service Gate Operators
Install or Service Gates - Lift
Install or Service Gates - Slide
Install or Service Loop Detectors
So that we may best direct business opportunities to you, please provide the following information.
What is your current Service/Installation Rate Per Hour?
What is your Warranty?
Please attach a copy of your:
- Current Installation Contract
- Warranty
- Sales Brouchure