If you are interested in becoming an NG&G Service Provider, please complete the form below.
Your information will then be submitted to our Network Department for review.

NG&G has resale certificates in the following states; CT, FL, IA, NJ, NY, and TX. Any invoice for work performed in these states should not have sales tax included in the price as NG&G will remit directly to the state. For a copy of the resale certificate, please click here. Select your state and print down a copy for your records.

    Questions marked by * are required.
* Company Name:
* Contact Person:
* Email Address:
* Physical Address:
Billing Address:
 * City:
State:
 Canadian Province:
 * Zip Code:
* Phone Number:
Cell Phone:
 Fax Number:

* Please specify your service coverage area:

* Are your invoices written in Canadian or US funds?      Canadian   US Funds

* Are you a Union company?      Yes   No

* Are there additional fees for Same Day Emergency Service?     Yes  No

If Yes, please specify below:

* Do you add any miscellaneous fees to your invoices?      Yes   No

If Yes, please explain:

* Number of Techs:

* Number of Vehicles:

Years in Business:

% of Commercial Work:
% of Residential Work:
* Hours of Operation:

* Do you sub-contract any of your work?               Yes   No

* Do you provide 24-hour emergency service?      Yes   No

* Do you have a digital camera available?             Yes   No

Please list each type of license you hold, along with the license numbers:

* Tax ID Number:

* Insurance: (Please select all that apply)
  • USD $1 Million Liability Coverage
  • Workers Compensation Insurance

  * Hourly Rate:
$
  * Two-Man Rate:
$

  * O.T. Rate:
$
  * Holiday Rate:
$

* Do you charge a travel/trip charge:      Yes   No

If yes, please specify your trip/travel charges:


* What are your payment terms?:     



* Please select the services you provide (Select primary trades only):

  • Appliance M&R
  • Automatic Doors
  • Awning repairs
  • Backflow Testing
  • Bollards / Curbing
  • Beverage Machines
  • Building Automation
  • CCTV
  • Carpet Cleaning
  • Chiller Maintenance
  • Concrete
  • Data Cabling
  • Delivery Svc.
  • Disaster Recovery
  • Dock Levelers
  • Doors
  • Electrical
  • Elevator
  • Exit Lighting
  • Extinguisher Service
  • Fencing
  • Fire Alarm
  • Fire Extinguishers
  • Fire Sprinklers
  • Flooring
  • Floor Tile
  • Food Service Appliances
  • Forklifts
  • Furniture
  • Gates
  • Generators
  • Glass/Glazing
  • Handyman/General Repairs
  • Hazardous Material Handling
  • HVAC
  • General Contracting
  • Hydrolics
  • Janitorial
  • Kitchen Equipment
  • Lighting
  • Landscaping
  • Lamp Recycling
  • Lock & Key
  • Masonry
  • Mold Remidiation
  • Moving
  • Overhead Doors
  • Painting
    		•
  • Pallet Jacks
  • Parking Lot Maintenance
  • Pest Control
  • Plumbing
  • Refridgeration
  • Restoration
  • Rest Room Partitions
  • Roofing
  • Safes
  • Security Systems
  • Sewer/Septic
  • Shipping
  • Signage
  • Snow Removal
  • Storage
  • Storefront Framing
  • Trash Compacting
  • Vending Machines
  • Water Extraction
  • Water/Ice Machines
  • Window Filming
  • Window Washing
  • Wild Animal Removal
    		•

    Please list any other services you provide:

    Please list at least 3 client references:

    * Do you provide services for any other national / regional companies?   Yes No

    If Yes, please list the companies below and the services you provide:


    * The following agreements are required in order to be considered:

    • I certify that any client information obtained through NG&G will be kept confidential and will be used only to better perform the services requested by NG&G directly.

    • I certify that I will not solicit any work, etc from any NG&G client.

    • I give NG&G full permission to run a background check on my company and employees at any time if desired.

    • I certify that the rates that I have submitted are the best available through my company.

    • I certify that I have answered the above questions honestly and accurately to the best of my knowledge.

     

    		 
    Name :
    Company :
    Email :
    Phone :
    Questions :
      
     
     
     
     
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