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PARTNER WITH US
Contractors please complete this form with your information to partner with us on offering fixed rate financing to your customers. Once we receive your form we will contact you asap. We look forward to working with you soon!
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COMPANY NAME
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Your answer
OWNER NAME / MANAGING PARTNER NAME
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Your answer
EMAIL ADDRESS
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Your answer
BEST PHONE NUMBER TO CONTACT YOU
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Your answer
OFFICE ADDRESS
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Your answer
HOW DID YOU HEAR ABOUT US?
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Your answer
HOMEIMPROVEMENTS THAT YOUR COMPANY DOES
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ROOFING
HVAC
ELECTRICIAL
PLUMBING
Other:
COMPANY TAX ID #
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Your answer
STATE CONTRACTORS LICENSE NO.
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Your answer
YEARS IN BUSINESS
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Your answer
COUNTIES THAT YOU SERVICE
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Your answer
DO YOU HAVE YOUR STATE OF FLORIDA HOME IMPROVEMENT RETAIL INSTALLMENT SELLER LICENSE YET?
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Yes
No
DO YOU CARRY WORKERS COMPENSATION INSURANCE?
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Yes
No
HAVE YOU OFFERED ANY FINANCING TO YOUR CUSTOMERS BEFORE?
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Yes
No
DO YOU ACCEPT CREDIT CARDS FOR PAYMENT?
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Yes
No
WHAT IS AN AVERAGE PRICE FOR YOUR REPAIRS?
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LESS THAN $10,000
$10,000 TO $20,000
$20,000 TO $30,000
$30,000 TO $40,000
MORE THAN $40,000
Do you have any questions for us?
Your answer
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