For what type of location do you need a cleaning service?   Commercial/office location   Industrial/manufacturing/warehouse location   Retail location   Medical facility (hospital/physician office/medical clinic)   Restaurant/bar/night club   Educational facility   Church   Other       Do you currently have a company providing an office cleaning service for your organization?   Yes Please indicate current provider, if known:   No       How often will you need this service?   Daily   Two times per week   Weekly   Two times per month   Other       Approximately, what is the square footage of your location?   0 - 2,499 sq. ft.   2,500 - 4,999 sq. ft.   5,000 - 9,999 sq. ft.   10,000 - 49,999 sq. ft.   50,000 - 99,999 sq. ft.   100,000+ sq. ft.   Not sure       What additional services are you interested in?   Carpet shampooing/stain removal   Wood floor care   Exterior window cleaning   Ceiling or wall cleaning   Drapery/upholstery care   Other (please specify):       Please describe any additional requirements you may have for your cleaning services         Contact Information:   Name: Company:   Street Address:   City: State: Zip Code:   Phone: Fax:   Email:   Best time to call:

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