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Service Network Application

Please provide us with the information requested below and one of our service recruiters will contact you shortly.

* Indicates Required Fields

    Tell Us About Your Company:

    What is your position at your company?

    How Do You Operate Your Company:

    What types of insurance does your company carry? (Check all that apply.)
    General LiabilityWorker's CompensationCommercial VehicleNone of the above

    Tell Us About Your Service:

    Please select the farthest distance beyond your primary zip code that you service:

    Hours of Operations *

    Mon - Fri: to     Sat: to     Sun: to

    What type(s) of screening do you perform on each of your technicians? (Check all that apply.)
    Background InvestigationDrug ScreeningNeither Background Investigation or Drug Screening

    Do your technicians wear uniforms?

    Are your trucks branded with your company name and logo?

    What products do you service? (Check all that apply.)
    Major AppliancesConsumer ElectronicsPersonal Computers and TabletsLawn and Garden EquipmentWireless Mobile DevicesJewelry and WatchesFitness EquipmentHVAC EquipmentGarage Door OpenersPools & SpasLawn SprinklerElectricalPlumbingDuctwork;Other

    Service Labor Warranty Period:
    Note: Servicers Labor warranty will carry a minimum of thirty (30) days from the date of covered service.

    Service Parts Warranty Period:
    Note: Servicers Parts warranty will carry a minimum of thirty (30) days from the date of covered service.

    Pricing Information:

    Hourly Rate:

    Flat Rate:

    Trip Charge:


    Preferred Payment Option:

    Type of Service Provided:

    In Home Service CallsCustomer Carry-in   (Check all that apply.)

    Brands You're Factory Authorized: *

    Other Brands You Service:


    Click “Submit” button to send your request to one of our service recruiters.

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