|
First Name |
|
|
Last Name |
|
|
Organization |
|
|
Work Phone |
|
|
Fax Number |
|
|
E-mail |
|
|
First Area Measurements |
|
|
Second Area Measurements |
|
|
Third Area Measurements |
|
|
Stairs: Please count each riser (step) |
|
|
Any other areas to be cleaned? |
|
|
When was the last time carpets were cleaned? (mm/dd/yyyy) |
|
|
|
|
|
Any upholstery? |
|
|
Type and Number |
|
|
Hard Floor Surfaces: Type? |
|
|
Measurements |
|
|
What is the current maintenance schedule for floor care? |
|
|
|
|
|
Are you interested in our duct cleaning services? |
|
|
Please provide floor plan with number of ducts noted |
|
|
|
|
|
Do you have a certain date in mind for this work to be completed? |
|
|
Dates: |
|