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Contractor Application

Contact Information
First Name:     Initial:     Last Name:
Title:    
E-mail:  

 Company Information
Company Name:
Street Address:    
Address Line 2:
City:        State/Province:        Country:
Postal/Zip Code:   


Phone Number:        ( )   -  

Fax Number:        ( )   -  
Web Site:
 
Business Information
Primary Business Type (i.e., plumbing, HVAC contractor):  
What year was this company founded?  
How many service technicians do you employ?    
How many installers do you employ?    
Do you provide commercial boiler start-up service?    
Do you have spanish speaking technicians?  
What is your plumber or contractor license number?  
Are you bonded and insured?  
Do you offer financing?  


 Service Types Offered
24-hour Emergency Service
Which fuel types do you service (check all that apply):    
 Which types of services do you provide (check all that apply):

Boiler Installation:     
                          
Boiler Service:
                        
Other Services:
           
  
Number of WM boilers installed per year?    
Please indicate which type(s) of testing equipment you own (check all that apply):
How many hydronic heating training classes have you attended in the prior three years?      
How many Weil-McLain training classes have you attended in the past three years?             
Are any of your technicians NATE certified?
 Do you have any other certifications (please list)?

I certify that all statements are true and correct.  





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