Become An Installer

Business Name*

Business Activities (Check all that apply)*

Epoxy Flooring Contractor
Flooring Contractor
General Contractor
Demo, Substrate and Concrete
Drywall, Polywall, FRP
Stainless Panels

DBA Name*

Check all that apply*

Kitchen Equipment
Cleaning and Maintenance
Plumbing
Electric
Carpentry
Hydraulic Cement
Specialty
Other

In Business Since*

Contact*

Title*

Email*

Phone*

Cell*

Date*

Office Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Warehouse Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Other Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

HR Profile

Number Of Employees*

Number Of Field Supervisors*

Number Of Employees Related To Flooring*

Number Of Project Managers*

Number Of Installation Crews*

Are Crews available 24/7*

Facilities Profile

Square Footage of Warehouse*

Loading dock with 52' trailer access*

Loading dock with 26' box truck access*

On site forklift access*

Climate controlled warehouse*

7,000+lb. rated raking system*

9 to 5 delivery acceptance*

Largest truck/ trailer capacity (pounds)*

Business Profile

Business Type*

Minority Ownership*

Veteran Ownership*

SBA 8(a) Certified*

Union Affiliated*

Business License*

One Million Dollar + Worker Comp*

One Million Dollar + General Liability*

Established D-U-N-S Number*

Legal Profile

Outstanding Judgements or Liens*

Bankruptcy or Financial Reorganizations*

Pre-Existing Contractual Obligations*

Security Background Checks on Crew*

Sales Profile

Sales Staff*

Customer Relationship Management Database*

Interested in Cooperative Marketing with Jet Rock*

Active with Social Media- Linked In, Facebook, Google+ Business*

How Long Have You Maintained a Website?*

What is Your Website Address or Addresses?

Existing Client(s)

Comments

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Become An Installer

Authorized Installer Preliminary Application

HR Profile

Facilities Profile

Business Profile

Legal Profile

Sales Profile