Service Registration Form

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Mervyn Mosley
6 years ago
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1 Service Registration Form Thank you for choosing Inspector Call Center. We re happy to serve you! Save the completed form to your desktop and to If you are paying by check, you can mail the hard copy along with payment. Please make checks payable to Inspector Call Center. Our Mailing address is: Inspector Call Center 4015 Wetherburn Way, Bldg. A, Suite 200 Peachtree Corners, GA Billing Information Card Type Visa MasterCard Discover American Express Card Number Expiration Date CVV Name (As is appears on the card) Phone Billing Address PAGE 1

2 Service Registration Form Company Name Month/Year company was formed Address Business Phone Fax Website Service Areas (Please attach the following) Map of your coverage area (please outline your service area and add notes if applicable) List the cities and zip codes covered in your service area Sales Pitch So we may accurately promote your company to callers, please list up to five (5) statements that would convince a caller to choose your company: (1) (2) (3) (4) (5) You may also include a brochure and/or other marketing materials, so we can get to know you better! Insurance Which type of insurance does your company carry? E&O Workman s Comp General Liability Payments Accepted Cash Check PayPal Visa MasterCard AmEx Discover Payment at Closing Yes No Additional Chg? $ PAGE 2

3 Inspection Agreement Do you require a contract to be signed by your client? Yes No If Yes, check all that apply Prior to inspection Anytime during or at the completion of inspection Prior to releasing the report Access Do you have an electronic lockbox key? Yes No Do you require a code for electronic lockbox access? Yes No Inspector Information (use a separate sheet for each inspector) Name Home Fax Mobile Office Year Inspector Started in the Home Inspection Industry Background experience (e.g., education, related experience such as construction, engineering) Affiliations, Memberships, Licenses, Certifications ASHI # ICC *Note in specific certifications NAHI State License # NACHI Mold Certification Radon Certification Termite Certification Septic Certification Well Certification Messages (that we will take for you during the day) Phone message preference: Text Mobile phone can be given out for messages Mobile phone can be given for emergency/urgent messages only PAGE 3

4 Scheduling Times (Example: Start times - 9 a.m. & 2 p.m., or 8 a.m., 12 p.m., 4 p.m. etc) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Earliest Start Time Latest Start Time Will you work on Sunday s? Yes No Extra Charge? $ Same-day appointments? Yes No Extra Charge? $ How long is the average inspection? Do you offer partial inspections? Yes No Inspection Report Computer generated report Hand-written report Given on site ed to client Mailed overnight to buyer Digital photos included Posted to internet site Is a copy of the report given to realtor? Yes No Only w/permission Do you have a sample report on your website? Yes No Home Inspection Pricing (if not set up in ISN - if possible, include copy of price sheet) Square Footage $ / sq ft (example $25/500 sq ft) Choose one: Total finished only Total finished and/or unfinished Home Price Purchase/Base Price $ / (example $100/$100,000) Bedrooms/Baths (base price of $ for bed & baths) Additional Bedroom $ Base Number of Rooms Additional Bathroom $ $ Per additional room Townhomes Includes: Exterior Interior Same price as single-family home Discount from single-family home price $ PAGE 4

5 Condo Includes: Exterior Interior Same price as single-family home Discount from single-family home price $ Mobile/Manufactured Includes: Exterior Interior Same price as single-family home Discount from single-family home price $ New Construction E-coli & Coliform - Nitrates & Nitrites - Lead - Radon - Pesticide - : Cost per test: $ (include extra page if you need to make list) Results back in days. Septic Yes No $ w/inspection $ w/o inspection Dye flow test Full Septic Inspection Mold Testing Yes No $ w/inspection $ w/o inspection Swab test (Results in Wall cavity test (Results in Air sample (Results in days) days) days) Laser particle counter used Mold clearance testing $ Thermal Scan $ w/inspection $ w/o inspection Results in days or on site Lead Paint Testing $ w/inspection $ w/o inspection Results in days or on site X-ray machine used Asbestos Testing $ per sample Results in days PAGE 5

6 Soil Sampling $ w/inspection $ w/o inspection Results in day Oil Tank Testing $ w/inspection $ w/o inspection Results in day Above Ground Underground Spa $ Pool $ Pool and Spa $ Irrigation System Lawn Sprinklers $ Drip System $ Commercial Properties Check which information is needed so we may contact you for price quote Square footage Age Foundation type Number of HVAC units Type of property Number of bathrooms Additional Fees Crawl space/raised foundation $ Old house fee $ over years Detached building w/electricity and water $ Detached building (structure only) $ Additional garage $ Additional HVAC units $ Additional water heaters $ Additional electrical panel $ Mother-in-law apartment $ Moisture meter $ Gas leak test $ Carbon monoxide test $ Please feel free to include any additional information that we will need when booking inspections for your company. PAGE 6

Registration Form Instructions (No worries, it s very simple and easy!)

The Leader in Integrated Customer Service & Call Handing Solutions Exclusively for Home Inspectors Registration Form Instructions (No worries, it s very simple and easy!) Thank you for choosing America