Service Request Form

15 April 2013, Comments: 0

Service Request Form

Please note that All Requests must be submitted via, in person, fax or email (preferred). ALL Requests for delivery MUST be accompanied with a detailed map of the pickup/delivery location to implement service. Maps should be as detailed as possible and contain familiar landmarks to reference. It is the customer`s responsibility to notify of any PPE required to access delivery locations. Please allow 3 - 5 business days to complete Requests.

Company Name:
Customer #:
Contact Name:
Cleaning ServicesMat RentalCoverall RentalOther Specify:
Frequency: Weekly2x/Wk3x/Wk5x/Wk7x/WkBi- WeeklyMonthlyCall-InOther

If other please specify:
Preferred Days: MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Repairs Required: YesNo
PPE Required for delivery Location: YesNo Specify:

Note: Unless garment inventory tracking sheet is provided, COVERALL`s Count Must be deemed as Accurate


Accounts Payable Contact Information
Ph: (780) 791-0766 Email: Fax: (780) 743-4314