Preferred Service Partner Registration Form

Please provide the following contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Telephone
FAX
E-mail
URL

Coverage Availability:

3 x 7 (24 hrs, 7 days/week)
2 x 7 (First and second shift, 7 days/week)
1 x 5 (First shift, 5 days/week)

What on-site response times do you guarantee:

2 hours
4 hours
Same business day
Next business day

Equipment/Platforms Supported:

AS400    RS6000    Servers    System Printers   

Desktop Printers Networks    Workstations       Plotters

Manufacturers support with on-site service:  (ie, IBM, HP, Compaq, Sun, Dell, Toshiba) 

Manufacturers supported with depot service:  (ie, IBM, HP, Compaq, Sun, Dell, Toshiba)

Other service provided:

Installs    Adds    Moves    Changes    Networking    Help Desk
Cabling

What geographical areas do you cover? (States)

What types of certifications does your company and/or techs hold? (ie, A+, MCSE, CNE). Please provide documentation.

We are an authorized dealer for the following manufacturers:

We are an authorized service center for the following manufacturers:

Please detail your service rates:

Standard On-Site Hardware Rate
After Hours/Weekend
Travel
Networking
Depot Service Rate
Minimums/billing increments

Do you provide loaner equipment?  Yes    No
Do you sell parts?  Yes    No

Other information: