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| Name or Company Name: | |
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| Contact Name: | |
| Street Address: | |
| Address Continued: | |
| City: | |
| State: | |
| Zip Code: | |
| Cell Phone: | |
| Work Phone: | |
| Home Phone: | |
| Fax: | |
| Email: | |
| Service interested in: | |
| Approx size of home or office: | |
| Number of restrooms: | |
| How many days per week: | |
| How many hours per service: | |
| What type of floors: | |
| What type of facility: | House Apartment Commercial Private Office Industrial Other
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| Cleaning duties needed: | |
| Specific Cleaning Services: Steam Carpet Cleaning: |
Client must provide equipment |
| Shampoo Carpet: | Client must provide equipment |
| Upholstery Cleaning: | |
| Clean Windows: | |
| Wax Floor: | Client must provide equipment |
| General Cleaning: | |
| Strip Floor: | |
| Other: | |
Send mail to
messbusters@aol.com with
questions or comments.
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