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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
Service Department
Machine Repair
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
*
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
