Name*
Organization*
Street Address*
Address (cont.)
City*
State/Province*
Zip/Postal Code*
Work Phone*
E-mail*

What is the total square footage  of the facility we are to clean	Less than 10001001 - 20002001 - 30003001 - 40004001 - 50005001 - 60006001 - 75007501 - 90009001 - 1050010501 - 1200012001 - 1400014001 - 1600016001 - 1800018001 - 2000020001 - 2200022001 - 2500025001 - 2800028001 - 3200032001 - 3600036001 - 4000040001 - 4500045001 - 5000050001 - 5500055001 - 6000060001 - 6500065001 - 7000070001 - 75000More than 75000
How often each week do you wish us to clean?	1234567
How many people do you employ?	1-10 11-20 21-30 31-40 41-50 51-65 66-80 81-100 Over 100
What is the condition of the facility?	New Excellent Good Fair Poor
How many bathrooms are there?	1 2 3 4 5 6 7 8 9 10 Over 10
What percent of the flooring is carpet?	Less than 50% 50% or more
What is type of business is it?	Airport and Related Services Apartment/Condominium Complex Automobile Sales/Service/Leasing Automotive Repair Bank/Financial Institution Beauty Services/Barbers Child Care/Day Care Services Construction and Related Services Convenience Stores Education/School Food Service Fuel Oil/Gasoline Golf Club/Country Club Government New Home Builder Health Care/Medical Services Hotels and Motels Janitorial/Cleaning Services/Supplies Media Moving and Storage Printing Service Professional Services Real Estate Office/Services Restaurant Retail Store Transportation Utility Company Warehouse Other Industry
If other than above, describe your business.
What time would you like us to  provide our services?	6PM-12PM Other Specify Below
Between and Weekdays
What did you like/not like about your last or current cleaning service?
What do you expect from your cleaning service?
Other comments:

Disclaimer: The price range provided by this estimator is only an estimate and is not binding on either party. A commitment of a firm price for services can only be made after Reliable Cleaning Services visits your facility and a formal proposal is prepared. This estimator is for use by legitimate businesses only, for the sole purpose of determining interest in our services. Any company or individual attempting to use any information from this estimator for use in price-fixing, unfair bidding practices or any activity that interferes with a fair pricing opportunity to our visitors requesting information from this site, will be selectively refused access to the estimator and may face legal action. Under no circumstances is this estimator to be used by a competitive business or one seeking information on behalf of another in a competitive business.

The information collected by this web site will be used only by Reliable Cleaning Services and will not be resold or shared with anyone else. We will contact all visitors to this estimator with the understanding that they are seeking information concerning our services and that Reliable Cleaning Services will be allowed to visit the mentioned premises to provide a formal proposal for services.