FacilityLync Vendor Inquiry Form Vendor Information Please fill out the following information to be considered as a FacilityLync Service Provider. Questions marked by * are required. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Company Name *Contact Person *Email *EmailConfirm EmailPhysical Address *LayoutCity *State *Zip Code *Phone *Cell Phone *Fax NumberWebsiteHow did you hear about us?Customer/ReferralGoogle/SearchEngine/IndeedLinkedInNetworking EventOthersService Coverage Area: Please specify your service coverage area by distance from your primary zip code. LayoutZip *Miles *10 Mile Radius20 Mile Radius30 Mile Radius50 Mile Radius60 Mile RadiusUnion Company *YesNoPlease Specify Below *Please explain *Layout% of Commercial WorkNumber of VehiclesYears in BusinessLayoutNumber of TechsHours of Operation (Days/Times)Licenses: Please List Each Type of License You Hold, Along With The License Numbers.LayoutProvide 24-hour Emergency Service *YesNoDoes Your Company Sub-Contract Work *YesNoLayoutTax ID Number *Insurance Requirements *USD $2 Million LiabilityUSD $1 Million AutoUSD $1 Million Workers CompensationPlease Specify Your Hourly Rates LayoutTravel/Trip Charge *YesNo$ Hourly Rate (Add Price Below)$ Two-Man Rate (Add Price Below) *Payment Terms *0% NET6010% NET4515% NET3020% NET15$ O.T. Rate (Add Price Below) *$ Holiday Rate (add Price Below) *Payment Method *CheckEFTAdditional Fees for Same Day Emergency Service: *YesNoSpecify Below *Miscellaneous Fees? *YesNoSpecify Below *LayoutServices Provided: Please select the primary trades your company specializes in. *Appliance RepairAwning RepairBrokerCleaning- Flooring/CarpetCleaning- JanitorialCleaning- WindowCompressorsConcrete/MasonryConstructionDelivery Service/MoversDisaster-Board UpDisaster- Fuel TruckDisaster- SandbagsDock RepairDoors- AutomaticDoors- Overhead/GateDumpsters/Trash RemovalElectrical- Certified ElectricianElectrical- Generator Repair/Hook UpElectrical- LightingElectrical- SignageElevator RepairEngineeringFencingFire Sprinkler & ExtinguisherFlooring RepairFork LiftGeneral ContractorHandyman/ General RepairHVACHVAC- RefrigerationLandscaping/Snow RemovalLocksmithMedi-CartMiscellaneousPaintingParking Lot- MaintenanceParking Lot- Paving/StripingPest ControlPlumbing- BackflowPlumbing- Certified PlumberPlumbing- IrrigationPlumbing- JettingPlumbing- Leak DetectionPlumbing- Lift StationPlumbing- Major UndergroundPortable RestroomsPressure CleaningPump Truck/Grease Trap/SepticRestoration/Water ExtractionRoofing- ContractorRoofing- GutterSheet MetalStorageWarehouse Racking SystemWaterproofingWeldingWindow- Glass/Mirror/TintingLayoutOther Services Provided: Please list any other services you provide. Provide Services for Other National/Regional Companies *YesNoClient References: Please list at least 3 client references. *Please list the companies you provide service for.Required Agreements *I certify that any client information obtained through FacilityLync will be kept confidential and used only to better perform the services requested.I certify that I will not solicit any work from any FacilityLync client.I give FacilityLync full permission to run a background check on my company and employees at any time if desired.I certify that the rates submitted are the best available through my company.I certify that the answers provided are honest and accurate to the best of my knowledge.Submit