Home
Upcoming Events
Products
Aerosols
Closed Loop
Carpet Care
Degreasers
Deodorizers
Dietary/Kitchen
Disinfectants
Equipment
Floor Cleaners
Floor Care
>
Restore
Floor Care - Wood
Floor Strippers
Hand & Body Wash
Janitorial
Laundry
Specialty
Window Cleaners
Resources
Training & Support
Industries Served
SDS
Vendors Page
Contact Us
Meet Our Team
History
Blog
Home
Upcoming Events
Products
Aerosols
Closed Loop
Carpet Care
Degreasers
Deodorizers
Dietary/Kitchen
Disinfectants
Equipment
Floor Cleaners
Floor Care
>
Restore
Floor Care - Wood
Floor Strippers
Hand & Body Wash
Janitorial
Laundry
Specialty
Window Cleaners
Resources
Training & Support
Industries Served
SDS
Vendors Page
Contact Us
Meet Our Team
History
Blog
Dish Machine Request Form
Complete the questionnaire below. If approved by the Director of Sales, the normal process will begin for obtaining a dish machine and scheduling the installation
*
Indicates required field
Rep Name
*
Today's Date
*
Customer Name
*
Address
*
City
*
County
*
Type Of Establishment
*
Count info for Non-Restaurant Accounts i.e. # of Beds or Inmates
*
How Many Seats Are in Restaurant?
*
Average Nightly Covers (number of eating customers/night)
*
Is there a Banquet Room?
*
Yes
No
Is There a Second Dining Room
*
Yes
No
Meals they Serve (Check all that apply)
*
Breakfast
Lunch
Dinner
Late Night
Days of Week They Are Open
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Weekday Hours of Operation
*
Weekend Hours of Operation
*
Estimated Annual Sales Volume for Dietary Chemicals
*
Manufacturer/Model of Dish Macine
*
Lease Type
*
36 Month Open End Lease
36 Month Lease to Own With $1.00 Buyout
48 Month Lease to Own With $1.00 Buyout
Other - Please Fill in Below
Lease or Sale Price
*
Other - "Lease Types"
*
Additional Ancillary Products
*
3-Sink
Housekeeping
Paper
Handsoap
Additional Comments
*
To assist the Service Technicians, please provide and name and phone number for an on-site contact for the survey
Contact's Name
*
Phone Number
*
Submit
