Contractor Registration FormAndry Chandra2023-08-29T11:14:39+10:00

CONTRACTOR REGISTRATION FORM

Contractor Registration Form

Business Name *

Contact Name *

Address *

Phone *

Email *

State For Services *

NSW

VIC

QLD

SA

VA

ACT

NT

TAS

Service Area *

Hardware / Repairs Rates ex gst

Service Call $ *

Hourly Rate $ *

Travel Fee $ *

Revist Fee $ *

IT / Installation Rates ex gst

Service Call $

Hourly Rate $

Any Extra Cost $

Brands

HP

Serviced

Access to Part

Konica Minolta

Serviced

Access to Part

FujiFilm

Serviced

Access to Part

Sharp

Serviced

Access to Part

Canon

Serviced

Access to Part

Oki

Serviced

Access to Part

Kyocera

Serviced

Access to Part

Ricoh

Serviced

Access to Part

Lexmark

Serviced

Access to Part

Epson

Serviced

Access to Part

Brother

Serviced

Access to Part

Toshiba

Serviced

Access to Part

Samsung

Serviced

Access to Part

Other

Serviced

Access to Part

Equipments Serviced

Equipments *

Laser Printer

Inkjet Printer

Photocopier

MFC

Scanner

Shredder

Plotter

OtherOther

Service Capacity

BreakFix Service

IT Services

Run Up an Installation of Hardware

Set Up Scan

Email

Folder

Cloud

Set Up Mac

Set Up Windows

Miscelaniouses

No. Of Techs

Forklift Access

Y

N

Warehouse

Y

N

Store Room

Y

N

Rebuild Drums / Fusers

Y

N

Insurance

Public Liability

Work Compensation

Note

If you are human, leave this field blank.

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