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Home
News & Events
Products
Aerosols
Closed Loop
Carpet Care
Degreasers
Deodorizers
Dietary/Kitchen
Disinfectants
Equipment
Floor Cleaners
Floor Care
Floor Care - Wood
Floor Strippers
Hand & Body Wash
Janitorial
Laundry
Specialty
Window Cleaners
Resources
Training & Support
Service Department
Machine Repair
Industries Served
SDS
Affiliations
Vendors Page
Contact Us
Meet Our Team
History
Blog
COVID-19
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
*
Average Nightly Covers (number of eating customers/night)
*
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
Is there a Banquet Room?
*
Yes
No
Is There a Second Dining Room
*
Yes
No
Seasonal Business
*
Yes
No
If seasonal, provide the number of months open:
*
Hours of Operation
*
Manufacturer/Model of Dish Machine
*
Is the Dish Machine New or Reconditioned?
*
New
Reconditioned
Lease Type
*
36 Month Open End
Dish Machine Chemical Program
36 Month to Own w/ Buyout
48 Month to Own w/ Buyout
Other - "Lease Types"
*
Lease or Sale Price
*
Is there a water softener at this location?
*
Yes
No
Provide the results of the water hardness drop test:
*
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
