EVALUATION FORM

Enter your details

Please complete the sections relevant to your type of business in the form below and click on submit.

1. How long has the business been in operation?

  0 to 1 years
  1 to 2 years
  2 to 3 years
  3 to 4 years
  more than 4 years

2. How does the business operate?

Business Hours only
24 Hours

3. Do you have full and comprehensive professional indemnity insurance?

Yes
No

If Yes, name of insurer

and policy number

4. Have you been approved by an Insurance Company?

Yes No

5. Have you been approved by a Manufacturer?

Yes No

6. Do you belong to a Trade Association?

Yes No

7. Are you VAT registered?

Yes No

8. Please indicate if any of the following the manufacturers and insurance companies have officially approved you as a contractor or service provider, and if you belong to any trade association. (if so, you will need to provide us with the name and telephone number of the person in that organization who can verify the approval)
(all applicants)

DEFY

Yes No

AEG

Yes No

KELVINATOR

Yes No

OCEAN

Yes No

Santam

Yes No

Auto & General

Yes No

Mutual & Federal

Yes No

SA Eagle

Yes No

Outsurance

Yes No

Hollard

Yes No

IOPSA

Yes No

ECASA

Yes No

MBA

Yes No

Others (Please specify)

For each organisation that you selected "Yes" for above, please provide
the organisation name, contact person's name and telephone number.

eg. DEFY, John Smith, 076-123-4567
AEG, Nigel Green, 082-123-4567

9. Please indicate number of each type available and/or employed:

eg. 1

  LDVs
  Artisans (Trade test certified)
  Labourers

10. Are all Vehicles/Drivers equipped with Radio Communication/Cell Phones?

Radios Cell Phones

11. Are any of the vehicles currently in use older than 5 years?

Yes No

12. Do all the above vehicles possess a full service history?

Yes No

13. Is your company BEE?

Yes No

14. Are you willing to invoice our corporate clients directly ?
(Payments are processed on a 30 day basis)

Yes No

15. Do you stock emergency materials?

Yes No

16. Do you make use of sub-contractors?

Yes No

16. RESPONSE TIMES:

Within a radius of 20 km

0-30 min 30-60 min
1-2 hrs over 2 hrs

17. Which areas (towns and suburbs) are you prepared to service?
(all applicants)

18. Please list any areas (such as townships) that you are
specifically NOT prepared to service:
(all applicants)

19. Rates:

(All rates to excl VAT)	Normal Hours	After Hours	Sunday Pub Hol
1. Call-out (to include first hour’s labour)
2. Distance incl. in call-out fee
3. Rate per km thereafter
4. Labour rate per hour

20. Other relevant information you would like to add:

Company Name

Your Name

Position in Company

Business Phone

Business Fax

Cell Phone

Please enter this number in the box below