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First Name*
Last Name*
Phone Number*
Format: (000) 000-0000.
Email*
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
1. What type of facility needs cleaning?

OfficeProperty ManagementEducational (e.g. school)Restaurant / Café / BarMedicalCommunity (e.g. church)Warehouse / FactoryCar Dealership
Other Facility
2. Which type of service are you looking for?

General JanitorialFloor CareWindow CareDay PorterOutdoor Maintenance
Other Service
3. What is the approximate square footage of the total areas that need cleaning?
4. How often do you require cleaning services?

One off requirement1 day a week2 days a week3 days a week5 days a week7 days a week
5. How many of each area or room type does your facility have? Fill in only what applies from the list below.
#Toilet/Urinal
#Office
#Cubicle
#Lobby
#Breakroom
#Kitchen
#Kitchenette
#Conference Room
#Floor (Level)
If you have any additional areas please describe your cleaning needs below.
6. How detailed of a cleaning service are you looking for on a scale from 1 to 3?
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