104 Question ReviewCurrent Vendors

Client Information:

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Company Name
What Industry
Contact Name
Contact Title
E-mail
Tel
FAX
Address
City
State
Zip
Web Address

What type of new customer submission is this?

Please give customer specific information here (ex. prefers "Norman" & hates "Norm") :

People Information

# of Owners/Partners    # of Full Time    # of Part Time    # of Contractors

Gross Receipts last fiscal year:    Payroll (w/o owners)   

Fed Tax ID#    UITR # (unemployment #)    Total # of Emp.

Workers Comp Features:

Auto Ins.  Features:

Building Information

Own/Lease Bldg?   Year Building Built:    Fire and/or Security? 

exterior doors     exterior windows     alarm pulls     alarm strobes    

Fire/Security Features:

# of bathrooms:      # of Stairwells:      # of Floors:

Gen Liability Features:

Square footage of buildings     (by the thousands)    Scale drawing of building incl:    

Cleaning Frequency:   Contract include supplies    

Onsite storage of supplies/machines:    12 Months Usage Print out of Supplies  

Janitorial  Features:

Postage Machine:

Payment Includes:     Postage Pd/mo    Letters/day:  

Sum of remaining payments:   Scale w/Machine   Print Lables

Mail mach  Features:

Phones Specs:

Ave Minutes Local  L.D. (long distance)     $/ min over Local L.D.  

Ave Minutes Regular L.D. (long distance)     $/ min over Regular L.D.  

Ave Minutes International L.D. (long distance)     $/ min over Intn'l Local L.D.  

Long Distance  Features:

Cell Service Features:

Data Line Features:

Regular Phone Features:

Voice Mail Lines:     Voice mail Prompts:     Paging Lines:     Answering Service

Phone System Lease:     # Cell Phones:     Total Cell Minutes:   (in 100s)

Text msgs/mo :     # lines to roll over:     # of Fax Lines:    ISP Type:  

Trash:

Trash Picked up   days per   Size of Container:    type:

How often is a roll off used    days per    HazMat Used:   Recycling Used:

Trash Service Features:

Web Hosting & ISP Specs:

Use to design website:   Domain 1:   Domain 2:

Domain 3:   Domain 4:   Domain 5:

Server Type: Data Lines Used Simultaneously:   Security Cert Used:

Shopping Cart Capability:   Credit Card Processing Capability:   Other:

Hosting HDD space/ month:   Bandwidth/ month:

Webmaster name:    Phone #:    email:

# of emails   # of email forwards:   # of auto Reply emails:

Accept payment on the web:   currently use:

Use web based database:   currently use:

Web Hosting Features:

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 104 Question ReviewCurrent Vendors

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Revised: 10/07/09.