Business Name
*
Contact Person
*
First Name
Last Name
Installer Portal Email
*
EMAIL USED TO LOG INTO THE SUPPLIER PORTAL
Phone Number
*
Format: (000) 000-0000.
Business Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
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California
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Connecticut
Delaware
District of Columbia
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State
Zip Code
Monday - Friday Business Hours
*
EX. 8AM - 5PM
Saturday Business Hours
*
EX. 8AM - 5PM
Sunday Business Hours
*
EX. 8AM - 5PM
We offer installation on the follow; Passenger/Light Truck, Max Width 295, Lowest Series 35, Max Rim 22", Max Flotation 35/12.50 - Is your location able to accommodate these?
*
Yes
No
Other
Do you charge for installation by series or rim size?
*
Series
Rim Size
We include installation, mounting, balancing, tire disposal, rubber valve stems, and TPMS rest only in our installation list prices.
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60 Series and Higher
*
Enter $ Amount
50-55 Series
*
Enter $ Amount
40-45 Series
*
Enter $ Amount
35 Series and Below
*
Enter $ Amount
14" - 15" - 16" Rim
*
EX. $18 - $20 - $25
17" - 18" - 19"
*
EX. $18 - $20 - $25
20" - 21" - 22'
*
EX. $18 - $20 - $25
What services do you offer at your shop?
Air conditioning
Air and Cabin Filter Replacement
Wheel Alignment
Battery Replacement
Brake Services
Classic Cars
Coolant System Services
Diagnostics
Diesel Repair
Drivetrain
Electric Vehicles
Electrical Repair
Engine Repair
Emissions
Muffler & Exhaust Services
Full Mechanical
Headlight & Taillight Services
Hybrid Vehicles
Inspections
Installation of Large Tires (20" or Above)
Oil Change / Oil Filter Replacement
Preventative Maintenance
Run Flat Services
Shocks & Struts
Steering
Suspension
Tire Pressure Mounting System (TPMS) Service
Transmission Repair
Tire Storage (winter, summer)
Windshield Wipers & Fluid
Shuttle Service
Waiting Room
WI-FI
Other
Would you be open to offering "Free Lifetime Rotations" to customers choosing your location for install?
*
Yes
No
In addition, if you join as an installer now you can earn an additional 5% if you sign up for our SimpleService program. You will be redirected to learn more after you submit this form. Visit: www.simple360.com/simpleservice for more information!
*
Yes
No
Sales Tax Exemption Certificate
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