- Business Name:*
- Business Address:
- City:
- State:
- Zip:
- Contact Name:*
- Contact E-Mail Address:*
- Contact Telephone:*
- Paint Supplier, Dist., or Jobber:
HazWaste (hauler) disposal company:
Paint/Chemical Product Mfg. (primary):
- Number of wrk orders(repair orders) per month:
-
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- Total No employees: (incl owner/mgrs)
- Number of owned vehicles (trucks, cars, etc.):
- Building square footage:
- Property square footage:
- Average gross per work order:
- Employee payroll cost (per month):
- Est. gross income (per month):
- Avg. electric bill (per month):
- Ave. gas heat bill (per month):
- Avg. water bill (per month):
- Avg. HazWaste bill (per month):
- Insurance cost (per yr):
- Workers comp cost (per yr):
- Insurance renewal date (mo/yr):
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