Servicer Sign-Up | Marvel Refrigeration

Are you tax exempt?*

Click here to download this form, fill out, and attach Attach Uniform Sales And Use Certificate – Linked Above *

Servicer Info

Name *

Phone*

Email*

Address*

City*

State*

Zip/Postal Code*

Type of business*

Resale #*

Federal Tax ID #*

Dunn & Bradstreet Number*

Officer name & title

Liability Insurance Info

Insurance company*

Agent name*

Address*

City*

State*

Zip/Postal Code*

Policy #*

Coverage limits*

Banking

Terms requested*

Payment Terms
Credit Card

Bank reference*

Trade reference 1*

Trade reference 2*

Trade reference 3*

Areas of Coverage

Zip codes covered* (separated by comma)

Training & Expertise

Number of technicians*

Certifications*

Refrigerator brands you have serviced*

Ice machine brands you have serviced*

What type of vacuum pump do you use?*

What type of volt meter do you use?*

Hours of operation (M-F)*

Hours of operation (Sat)*

Are you open on Sundays or Holidays?*

Do you service R600a refrigerant?*

Do you facilitate product exchanges?*

Rates

Requested service call flat rate*

Out of area mileage rate*

Sealed system repair flat rate*

In consideration for an account, said business promises to pay for all purchases. In the event any third parties are employed to collect any outstanding or disputed monies owed by said business the undersigned agrees to pay reasonable collection costs, including attorney fees, whether or not litigation has commenced, and all costs of litigation incurred. The undersigned represents that he/she has the authority to execute this credit agreement on behalf of the business identified.

Servicer Sign-Up / Update Form