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Partner Profile Interest Form

Welcome and thank you for your interest in becoming an Express Facility Management Partner. Please complete the initial Partner Profile Interest form so our team can review your capabilities and determine where an Express Facility Management need may match.

Company Name

D&B Number

Address

Address 2

City

State

Zip

Are you a Minority Vendor?

Yes No

Contact Name

Contact Title

Contact Email

Contact Phone

Please list any additional service areas (including city and state) outside your business location.

What is your company's staffing capacity?

Can you support short notice increases in service or one-off requests?

Yes No

Do you have 24/7 response?

Yes No

What does your staffing model look like?

Please list any relevant equipment you have on hand:

Do you have a single point of contact?

Yes No

*If yes, please provide the email address or phone number

Do they have a backup point of contact?

Yes No

*If yes, please provide the email address or phone number

Do you have a customer portal or dedicated email address?

Yes No

*If yes, please provide a link to the portal

How do you plan to stay connected to Express?

Email Phone Other

What is your average communication response time?

Do you carry Commercial General Liability Insurance at a minimum of $1M/$2M

Yes No

Do you carry Commercial Automobile insurance at a minimum of $500,000?

Yes No

Do you accept payment terms of NET 30 (ACH-Direct Deposit or check only)?

Yes No

NetVendor Enrollment

If selected, do you agree to enroll in NetVendor? (agreement is mandatory to continue)

Please list any additional information relevant to consideration for enrollment with Express

COI

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866-726-9527

Partner Profile Interest Form

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