Household Provider Information Form
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Company Profile Information

 
What is your company full name? *

 
What is your office and cellphone number? *

 
What is your first name? *

 
What is your surname? *

 
What is your email address? *

 
List what areas do you cover? *

 
What is your fleet size?

How many vehicles do you have in your fleet (if applicable)?
 
Please provide us with your physical & Postal Addresses? *

 
Please provide us with your company registration, VAT number (if applicable)? *

 
Are you a building contractor? *

If your answer to this is yes you don't need to continue, just submit the form.
     
 
Costing structure

 
What is your call out Fee?

Please stipulate if after hours is different to office hours?
 
What is your hourly labour rate fee

Please stipulate if after hours is different to office hours?
 
Response Times

 
What is your response time in Urban areas?

 
What is your response times in Rural areas?

 
Are you prepared to go into Locations/ townships/ informal settlements?

     
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