Date:

Sales Rep :

Customer Name::

Address:

City: State: ZipCode:

Phone:

Contact:

Title:

Customer Type:

Owner:

How Long in Business: # of Locations

List of Locations:

Area Serviced:

Annual Sales:

Percentage of New Construction: Percentage of Replacement:

Present Line(s), How Long, and Sales $:

Last Price Iincrease? Future Increase?

Present Service (Excellent, Good, Fair, Poor): Lead time on Delivery (max)


 



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