omnisolutionsusa.com
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216.172.109.100
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URL:
https://omnisolutionsusa.com/RequestaQuote
Submission: On September 28 via manual from US — Scanned from DE
Submission: On September 28 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: quoteForm — POST /RequestaQuote/RequestQuoteSave
<form action="/RequestaQuote/RequestQuoteSave" id="quoteForm" method="post" name="quoteForm">
<article>
<div class="wrap">
<div class="cont-holder">
<section class="cont-body">
<div id="RequestaQuote"> <span style="color:Red;">
</span>
<input type="hidden" id="hiddenState" name="hiddenState">
<input type="hidden" id="hiddenTitle" name="hiddenTitle">
<input type="hidden" id="hiddenjobstate" name="hiddenjobstate">
<table>
<tbody>
<tr>
<th style="background-color:Yellow" colspan="2" align="left">Contact Info</th>
</tr>
<tr></tr>
<tr></tr>
<tr>
<td align="right">Business Name: </td>
<td align="left">
<input class="input-validation-error" data-val="true" data-val-required="The BusinessName field is required." id="BusinessName" name="BusinessName" type="text" value=""><span style="color:Red">*This field is required.</span>
</td>
</tr>
<tr>
<td align="right">Title: </td>
<td align="left"><select name="title" id="title">
<option value="0" selected="selected">Choose a title...</option>
<option value="31">Account Executive</option>
<option value="27">Account Representative</option>
<option value="116">Accountant</option>
<option value="30">Accounts Payable</option>
<option value="175">Accounts Receivable</option>
<option value="130">Acquisitions Analyst</option>
<option value="74">Acquisitions Associate</option>
<option value="123">Administrative Assistant</option>
<option value="57">Advertising</option>
<option value="108">Asset Manager</option>
<option value="143">Assistant Maintenance Manager</option>
<option value="22">Assistant Manager</option>
<option value="124">Associate Broker</option>
<option value="162">Associate Manager</option>
<option value="139">Asst. General Manager</option>
<option value="86">Asst. Manager</option>
<option value="103">Asst. Property Mgr.</option>
<option value="78">Asst. Vice President</option>
<option value="155">Asst. VP Specialty Leasing</option>
<option value="51">Broker</option>
<option value="147">Business Manager</option>
<option value="66">Center Manager</option>
<option value="93">Chairman</option>
<option value="144">Chairman of The Board</option>
<option value="43">Chief Executive Officer (CEO)</option>
<option value="50">Chief Financial Officer (CFO)</option>
<option value="149">Chief Information Officer</option>
<option value="39">Chief Operating Officer (COO)</option>
<option value="140">Co-Chairman</option>
<option value="154">Commercial Associate</option>
<option value="131">Commercial Project Manager</option>
<option value="14">Computer Programmer</option>
<option value="185">Consultant</option>
<option value="106">Controller</option>
<option value="118">Developer</option>
<option value="145">Development Manager</option>
<option value="54">Dir of Leasing/Comm. Ctrs</option>
<option value="105">Director</option>
<option value="99">Director of Acquisitions</option>
<option value="94">Director of Asset Mgmt.</option>
<option value="121">Director of Brokerage Services</option>
<option value="65">Director of Comm. Real Estate</option>
<option value="151">Director of Commercial Leasing</option>
<option value="90">Director of Corporate Comm.</option>
<option value="89">Director of Development</option>
<option value="49">Director of Leasing</option>
<option value="117">Director of Mgmt. Services</option>
<option value="92">Director of Operations</option>
<option value="112">Director of Properties</option>
<option value="75">Director of Property Mgmt.</option>
<option value="41">Director of Real Estate</option>
<option value="160">Director of Retail Leasing</option>
<option value="46">Director of Retail Properties</option>
<option value="109">Director of Sales</option>
<option value="115">District Manager</option>
<option value="15">Doctor</option>
<option value="18">Engineer</option>
<option value="183">Estimator</option>
<option value="129">Exec. Director</option>
<option value="63">Exec. Vice President</option>
<option value="97">Exec. VP Acquisitions</option>
<option value="159">Exec. VP Asset Management</option>
<option value="133">Exec. VP Center Mgmt.</option>
<option value="136">Exec. VP Development</option>
<option value="55">Exec. VP Finance</option>
<option value="96">Exec. VP Leasing</option>
<option value="138">Exec. VP Marketing</option>
<option value="29">Facilities Director</option>
<option value="28">Facilities Manager</option>
<option value="48">Facilities Supervisor</option>
<option value="135">Finance Director</option>
<option value="184">Finance Manager</option>
<option value="158">Financial Administrator</option>
<option value="142">Financial Consultant</option>
<option value="69">General Counsel</option>
<option value="16">General Manager</option>
<option value="40">General Partner</option>
<option value="12">Head of DMV</option>
<option value="171">Ice Ctl Chief</option>
<option value="24">Internet Services</option>
<option value="26">IT Consultant</option>
<option value="19">Lawyer</option>
<option value="87">Lease Administrator</option>
<option value="45">Leasing Agent</option>
<option value="83">Leasing Director</option>
<option value="84">Leasing Manager</option>
<option value="60">Leasing Specialist</option>
<option value="178">Maintenance Supervisor</option>
<option value="10">Manager </option>
<option value="80">Managing Agent</option>
<option value="76">Managing Director</option>
<option value="37">Managing Partner</option>
<option value="111">Marketing</option>
<option value="44">Marketing Director</option>
<option value="119">Marketing Manager</option>
<option value="177">Merchant Manager</option>
<option value="128">Miscellaneous</option>
<option value="11">MOD</option>
<option value="173">Mortgage Broker</option>
<option value="174">Night Operations Manager</option>
<option value="23">Office Manager</option>
<option value="102">Officer</option>
<option value="179">Operations Director</option>
<option value="182">Operations Engineer</option>
<option value="25">Operations Manager</option>
<option value="8">Owner</option>
<option value="20">Owners Wife</option>
<option value="42">Partner</option>
<option value="34">Planner</option>
<option value="169">Plow Chief</option>
<option value="70">Portfolio Manager</option>
<option value="1">President</option>
<option value="61">Principal</option>
<option value="82">Product Manager</option>
<option value="98">Project Director</option>
<option value="77">Project Manager</option>
<option value="9">Property Manager</option>
<option value="157">Property Services Director</option>
<option value="146">Real Estate Manager</option>
<option value="163">Realtor</option>
<option value="100">Regional Director</option>
<option value="21">Regional Manager</option>
<option value="132">Regional Property Manager</option>
<option value="150">Regional Vice President</option>
<option value="126">Research Director</option>
<option value="79">Retail Group</option>
<option value="166">Retail Leasing Manager</option>
<option value="113">Retail Properties Associates</option>
<option value="91">Retail Specialist</option>
<option value="7">Sales</option>
<option value="35">Sales Associate & Appraiser</option>
<option value="4">Secretary</option>
<option value="110">Secretary & Treasurer</option>
<option value="181">Senior Operations Manager</option>
<option value="176">Senior Project Manager</option>
<option value="170">Shovel Chief</option>
<option value="13">Site Manager</option>
<option value="165">Special Events Director</option>
<option value="85">Sr. Associate</option>
<option value="107">Sr. Leasing Agent</option>
<option value="168">Sr. Leasing Director</option>
<option value="134">Sr. Leasing Executive</option>
<option value="167">Sr. Project Manager</option>
<option value="68">Sr. Property Manager</option>
<option value="73">Sr. Vice President</option>
<option value="52">Sr. VP Acquisitions</option>
<option value="122">Sr. VP Asset Mgmt.</option>
<option value="114">Sr. VP Development</option>
<option value="64">Sr. VP Finance</option>
<option value="127">Sr. VP Leasing</option>
<option value="156">Sr. VP Management</option>
<option value="120">Sr. VP Marketing</option>
<option value="161">Sr. VP Operations</option>
<option value="153">Sr. VP Retail</option>
<option value="164">Sr. VP Retail Leasing</option>
<option value="172">Supervisor</option>
<option value="33">Tax Assessor</option>
<option value="3">Tech</option>
<option value="101">Treasurer</option>
<option value="148">Trustee</option>
<option value="125">Vice Chairman</option>
<option value="2">Vice President</option>
<option value="59">VP Acquisitions</option>
<option value="58">VP Asset Management</option>
<option value="53">VP Commercial Properties</option>
<option value="137">VP Commercial Services</option>
<option value="88">VP Construction</option>
<option value="152">VP Corp. Rel. & Mktg.</option>
<option value="95">VP Development</option>
<option value="81">VP Finance</option>
<option value="38">VP Lease/Mgmt.</option>
<option value="56">VP Leasing</option>
<option value="141">VP Management</option>
<option value="71">VP Marketing</option>
<option value="47">VP Operations</option>
<option value="67">VP Property Mgmt.</option>
<option value="104">VP Real Estate</option>
<option value="72">VP Retail</option>
<option value="62">VP Shopping Centers</option>
<option value="32">VP/Construction</option>
<option value="17">Website Designer</option>
</select></td>
</tr>
<tr>
<td align="right">First Name: </td>
<td align="left"><input class="input-validation-error" data-val="true" data-val-required="The FirstName field is required." id="FirstName" name="FirstName" type="text" value=""> <span style="color:Red">*This field is
required.</span>
</td>
</tr>
<tr>
<td align="right">Last Name: </td>
<td align="left"><input class="input-validation-error" data-val="true" data-val-required="The LastName field is required." id="LastName" name="LastName" type="text" value=""> <span style="color:Red">*This field is required.</span>
</td>
</tr>
<tr>
<td align="right">Address: </td>
<td align="left"><input type="text" id="txtAddress" name="txtAddress"></td>
</tr>
<tr>
<td align="right">City: </td>
<td align="left"><input type="text" id="txtCity" name="txtCity"></td>
</tr>
<tr>
<td align="right">State: </td>
<td align="left"><select id="State" name="State">
<option value="0">Choose A State</option>
<option value="53">Alberta</option>
<option value="6">Alaska</option>
<option value="5">Alabama</option>
<option value="8">Arkansas</option>
<option value="7">Arizona</option>
<option value="9">California</option>
<option value="10">Colorado</option>
<option value="11">Connecticut</option>
<option value="12">District of Columbia</option>
<option value="4">Delaware</option>
<option value="13">Florida</option>
<option value="14">Georgia</option>
<option value="15">Hawaii</option>
<option value="19">Iowa</option>
<option value="16">Idaho</option>
<option value="17">Illinois</option>
<option value="18">Indiana</option>
<option value="20">Kansas</option>
<option value="21">Kentucky</option>
<option value="22">Louisiana</option>
<option value="25">Massachusetts</option>
<option value="24">Maryland</option>
<option value="23">Maine</option>
<option value="26">Michigan</option>
<option value="27">Minnesota</option>
<option value="29">Missouri</option>
<option value="28">Mississippi</option>
<option value="30">Montana</option>
<option value="35">North Carolina</option>
<option value="36">North Dakota</option>
<option value="31">Nebraska</option>
<option value="33">New Hampshire</option>
<option value="1">New Jersey</option>
<option value="34">New Mexico</option>
<option value="32">Nevada</option>
<option value="2">New York</option>
<option value="37">Ohio</option>
<option value="38">Oklahoma</option>
<option value="52">Ontario</option>
<option value="39">Oregon</option>
<option value="3">Pennsylvania</option>
<option value="40">Rhode Island</option>
<option value="41">South Carolina</option>
<option value="42">South Dakota</option>
<option value="43">Tennessee</option>
<option value="44">Texas</option>
<option value="45">Utah</option>
<option value="47">Virginia</option>
<option value="46">Vermont</option>
<option value="48">Washington</option>
<option value="50">Wisconsin</option>
<option value="49">West Virginia</option>
<option value="51">Wyoming</option>
</select></td>
</tr>
<tr>
<td align="right">Zip: </td>
<td align="left"><input type="text" id="txtZip" name="txtZip"></td>
</tr>
<tr>
<td align="right">Email: </td>
<td align="left"><input class="input-validation-error" data-val="true" data-val-regex="Invalid Email" data-val-regex-pattern="^[\w-]+(?:\.[\w-]+)*@(?:[\w-]+\.)+[a-zA-Z]{2,7}$" data-val-required="The Email field is required."
id="Email" name="Email" type="text" value=""> <span id="errmail" style="color:Red"><span class="field-validation-error" data-valmsg-for="Email" data-valmsg-replace="true">The Email field is required.</span></span>
<br>
</td>
</tr>
<tr>
<td align="right">Work Phone: </td>
<td align="left">
<input type="text" id="txtPhone1" name="txtPhone1" size="2" maxlength="3" onkeyup="if (this.value.length == 3) quoteForm.txtPhone2.focus();">- <input type="text" id="txtPhone2" name="txtPhone2" size="2" maxlength="3"
onkeyup="if (this.value.length == 3) quoteForm.txtPhone3.focus();">- <input type="text" id="txtPhone3" name="txtPhone3" size="3" maxlength="4" onkeyup="if (this.value.length == 4) quoteForm.txtExt.focus();">ext. <input
type="text" id="txtExt" name="txtExt" size="4" maxlength="5">
</td>
</tr>
<tr>
<td align="right">Home Phone: </td>
<td align="left">
<input type="text" id="txtHomePhone1" name="txtHomePhone1" size="2" maxlength="3" onkeyup="if (this.value.length == 3) quoteForm.txtHomePhone2.focus();">- <input type="text" id="txtHomePhone2" name="txtHomePhone2" size="2"
maxlength="3" onkeyup="if (this.value.length == 3) quoteForm.txtHomePhone3.focus();">- <input type="text" id="txtHomePhone3" name="txtHomePhone3" size="3" maxlength="4">
</td>
</tr>
<tr>
<td align="right">Cell Phone: </td>
<td align="left">
<input type="text" id="txtCellPhone1" name="txtCellPhone1" size="2" maxlength="3" onkeyup="if (this.value.length == 3) quoteForm.txtCellPhone2.focus();">- <input type="text" id="txtCellPhone2" name="txtCellPhone2" size="2"
maxlength="3" onkeyup="if (this.value.length == 3) quoteForm.txtCellPhone3.focus();">- <input type="text" id="txtCellPhone3" name="txtCellPhone3" size="3" maxlength="4">
</td>
</tr>
<tr>
<td align="right">Fax: </td>
<td align="left" width="100">
<input type="text" id="txtFax1" name="txtFax1" size="2" maxlength="3" onkeyup="if (this.value.length == 3) quoteForm.txtFax2.focus();">- <input type="text" id="txtFax2" name="txtFax2" size="2" maxlength="3"
onkeyup="if (this.value.length == 3) quoteForm.txtFax3.focus();">- <input type="text" id="txtFax3" name="txtFax3" size="3" maxlength="4">
</td>
</tr>
<tr>
<th colspan="2" style="background-color:Yellow" align="left">Comments</th>
</tr>
<tr>
<td align="right">Comments: </td>
<td>
<textarea cols="36" rows="4" id="txtComments" name="txtComments"></textarea>
</td>
</tr>
<tr>
<th colspan="2" style="background-color:Yellow;width:100px;height:100px">
<span>Please double-check to make sure Required Fields have been filled out. Forms submitted without the Required information will not be processed.</span>
<br>
<br>
<input type="button" id="btnNext1" name="btnNext1" value="Submit" class="btn-submit">
</th>
</tr>
</tbody>
</table>
</div>
<div id="quotecontinue" style="display:none">
<table width="100%">
<tbody>
<tr>
<td colspan="3" style="background-color:Yellow">Job site info </td>
</tr>
<tr>
<td width="30%" align="right">Job site address: </td>
<td width="35%">
<div align="left">
<input name="job_address" type="text" class="quote-textbox" id="job_address" size="40" maxlength="50" value="">
</div>
</td>
<td width="35%"></td>
</tr>
<tr>
<td width="30%" align="right">Job site city: </td>
<td align="left">
<div align="left">
<input name="job_city" type="text" class="quote-textbox" id="job_city" size="40" maxlength="50">
</div>
</td>
</tr>
<tr>
<td width="30%" align="right">Job site state: </td>
<td align="right">
<select name="job_state" class="quote-textbox" id="job_state">
<option value="0">Choose a State...</option>
<option value="53">Alberta</option>
<option value="6">Alaska</option>
<option value="5">Alabama</option>
<option value="8">Arkansas</option>
<option value="7">Arizona</option>
<option value="9">California</option>
<option value="10">Colorado</option>
<option value="11">Connecticut</option>
<option value="12">District of Columbia</option>
<option value="4">Delaware</option>
<option value="13">Florida</option>
<option value="14">Georgia</option>
<option value="15">Hawaii</option>
<option value="19">Iowa</option>
<option value="16">Idaho</option>
<option value="17">Illinois</option>
<option value="18">Indiana</option>
<option value="20">Kansas</option>
<option value="21">Kentucky</option>
<option value="22">Louisiana</option>
<option value="25">Massachusetts</option>
<option value="24">Maryland</option>
<option value="23">Maine</option>
<option value="26">Michigan</option>
<option value="27">Minnesota</option>
<option value="29">Missouri</option>
<option value="28">Mississippi</option>
<option value="30">Montana</option>
<option value="35">North Carolina</option>
<option value="36">North Dakota</option>
<option value="31">Nebraska</option>
<option value="33">New Hampshire</option>
<option value="1">New Jersey</option>
<option value="34">New Mexico</option>
<option value="32">Nevada</option>
<option value="2">New York</option>
<option value="37">Ohio</option>
<option value="38">Oklahoma</option>
<option value="52">Ontario</option>
<option value="39">Oregon</option>
<option value="3">Pennsylvania</option>
<option value="40">Rhode Island</option>
<option value="41">South Carolina</option>
<option value="42">South Dakota</option>
<option value="43">Tennessee</option>
<option value="44">Texas</option>
<option value="45">Utah</option>
<option value="47">Virginia</option>
<option value="46">Vermont</option>
<option value="48">Washington</option>
<option value="50">Wisconsin</option>
<option value="49">West Virginia</option>
<option value="51">Wyoming</option>
</select>
</td>
</tr>
<tr>
<td width="30%" align="right">Job site zip: </td>
<td align="left">
<div align="left">
<input name="job_zip" type="text" class="quote-textbox" id="job_zip" size="40" maxlength="50">
</div>
</td>
</tr>
<tr>
<td width="30%" align="right">Company Web Site: </td>
<td align="left">
<div align="left">
<input name="website" type="text" class="quote-textbox" id="website" size="40" maxlength="50">
</div>
</td>
</tr>
<tr>
<td colspan="3" style="background-color:Yellow">Site info </td>
</tr>
<tr>
<td align="center">What services are you interested in?</td>
<td align="right">
<div style="margin:2px;padding:2px;"> Snow Removal (check all that apply)<input type="checkbox" name="chkServices" value="Snow Removal (check all that apply)" id="1">
</div>
<div style="margin:2px;padding:2px;"> Power Sweeping (check all that apply)<input type="checkbox" name="chkServices" value="Power Sweeping (check all that apply)" id="2">
</div>
<div style="margin:2px;padding:2px;"> Power Washing (check all that apply)<input type="checkbox" name="chkServices" value="Power Washing (check all that apply)" id="7">
</div>
<div style="margin:2px;padding:2px;"> Waste Management (check all that apply)<input type="checkbox" name="chkServices" value="Waste Management (check all that apply)" id="8">
</div>
<div style="margin:2px;padding:2px;"> Asphalt Sealcoating (check all that apply)<input type="checkbox" name="chkServices" value="Asphalt Sealcoating (check all that apply)" id="9">
</div>
<div style="margin:2px;padding:2px;"> Line Striping (check all that apply)<input type="checkbox" name="chkServices" value="Line Striping (check all that apply)" id="10">
</div>
<div style="margin:2px;padding:2px;"> Water Damage (check all that apply)<input type="checkbox" name="chkServices" value="Water Damage (check all that apply)" id="11">
</div>
<div style="margin:2px;padding:2px;"> Fire Damage (check all that apply)<input type="checkbox" name="chkServices" value="Fire Damage (check all that apply)" id="12">
</div>
<div style="margin:2px;padding:2px;"> HVAC (check all that apply)<input type="checkbox" name="chkServices" value="HVAC (check all that apply)" id="15">
</div>
<div style="margin:2px;padding:2px;"> Spring Clean Up (check all that apply)<input type="checkbox" name="chkServices" value="Spring Clean Up (check all that apply)" id="16">
</div>
<div style="margin:2px;padding:2px;"> Handyman Service (check all that apply)<input type="checkbox" name="chkServices" value="Handyman Service (check all that apply)" id="17">
</div>
<div style="margin:2px;padding:2px;"> Painting (check all that apply)<input type="checkbox" name="chkServices" value="Painting (check all that apply)" id="18">
</div>
<div style="margin:2px;padding:2px;"> Roof (check all that apply)<input type="checkbox" name="chkServices" value="Roof (check all that apply)" id="19">
</div>
<div style="margin:2px;padding:2px;"> Electrical (check all that apply) <input type="checkbox" name="chkServices" value="Electrical (check all that apply) " id="20">
</div>
<div style="margin:2px;padding:2px;"> Exterior Restoration (check all that apply)<input type="checkbox" name="chkServices" value="Exterior Restoration (check all that apply)" id="21">
</div>
<div align="right"> Other: <input type="text" id="other">
</div>
</td>
</tr>
<tr>
<td align="right">If this is a large site, may we store equipment on-site?</td>
<td align="center">
<input name="equipment" type="radio" value="yes"> yes <input name="equipment" type="radio" value="no"> no
</td>
</tr>
<tr>
<td align="right">Are you satisfied with your current level of service?</td>
<td align="center">
<input name="satisfied" type="radio" value="yes"> yes <input name="satisfied" type="radio" value="no"> no
</td>
</tr>
<tr>
<td align="right">May we have the name of your current contractor?</td>
<td align="right">
<input name="contractor" type="text" class="quote-textbox" id="time" size="25" maxlength="50">
</td>
</tr>
<tr>
<td align="right">When is the best time to call?</td>
<td align="right">
<input name="time" type="text" class="quote-textbox" id="time" size="25" maxlength="50">
</td>
</tr>
<tr>
<td align="right">How many parking spaces are at this location(if any)?</td>
<td align="right">
<input type="text" name="parkingqty" id="parkingqty" class="quote-textbox" size="10" maxlength="10">
</td>
</tr>
<tr>
<td width="30%" align="right"></td>
<td align="right">
<input type="button" id="btnBack" name="btnBack" value="BACK" class="btn-submit"> <input type="button" id="btnNext2" name="btnNext2" value="NEXT" class="btn-submit">
</td>
</tr>
</tbody>
</table>
</div>
<div id="quotequestions" style="display:none">
<div style="background-color:#EECF63;height:30px;font-weight:bold;font-size:18px; width:450px;">
<span>Requested Service Questions</span>
</div>
<table>
<tbody>
<tr>
<td>
<div style="display:none;" id="div1">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_1"> Snow Removal (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_0"> We require sidewalk snow removal </span>
<input type="hidden" name="que_0" value="We require sidewalk snow removal">
<input type="hidden" name="service_0" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_0" id="yes_0">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_1"> We require ice control on parking lot areas </span>
<input type="hidden" name="que_1" value="We require ice control on parking lot areas">
<input type="hidden" name="service_1" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_1" id="yes_1">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_2"> If a large site, may we store equipment at site </span>
<input type="hidden" name="que_2" value="If a large site, may we store equipment at site">
<input type="hidden" name="service_2" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_2" id="yes_2">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_3"> Are you satisfied with your current service? </span>
<input type="hidden" name="que_3" value="Are you satisfied with your current service?">
<input type="hidden" name="service_3" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_3" id="yes_3">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_4"> We can provide bid specifications </span>
<input type="hidden" name="que_4" value="We can provide bid specifications">
<input type="hidden" name="service_4" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_4" id="yes_4">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_5"> Other </span>
<input type="hidden" name="que_5" value="Other">
<input type="hidden" name="service_5" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_5" id="yes_5">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_6"> Roof </span>
<input type="hidden" name="que_6" value="Roof">
<input type="hidden" name="service_6" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_6" id="yes_6">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_7"> Commercial </span>
<input type="hidden" name="que_7" value="Commercial">
<input type="hidden" name="service_7" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_7" id="yes_7">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_8"> Industrial </span>
<input type="hidden" name="que_8" value="Industrial">
<input type="hidden" name="service_8" value="Snow Removal (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_8" id="yes_8">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div2">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_2"> Power Sweeping (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_9"> Are you interested in power sweeping services? </span>
<input type="hidden" name="que_9" value="Are you interested in power sweeping services?">
<input type="hidden" name="service_9" value="Power Sweeping (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_9" id="yes_9">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_10"> We have schematics or site plans </span>
<input type="hidden" name="que_10" value="We have schematics or site plans">
<input type="hidden" name="service_10" value="Power Sweeping (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_10" id="yes_10">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_11"> We can provide bid specifications </span>
<input type="hidden" name="que_11" value="We can provide bid specifications">
<input type="hidden" name="service_11" value="Power Sweeping (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_11" id="yes_11">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_12"> We need day porter services </span>
<input type="hidden" name="que_12" value="We need day porter services">
<input type="hidden" name="service_12" value="Power Sweeping (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_12" id="yes_12">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_13"> Other </span>
<input type="hidden" name="que_13" value="Other">
<input type="hidden" name="service_13" value="Power Sweeping (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_13" id="yes_13">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_14"> We need litter patrol </span>
<input type="hidden" name="que_14" value="We need litter patrol">
<input type="hidden" name="service_14" value="Power Sweeping (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_14" id="yes_14">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div7">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_7"> Power Washing (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_15"> Side of building </span>
<input type="hidden" name="que_15" value="Side of building">
<input type="hidden" name="service_15" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_15" id="yes_15">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_16"> Patio or deck </span>
<input type="hidden" name="que_16" value="Patio or deck">
<input type="hidden" name="service_16" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_16" id="yes_16">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_17"> Parking area </span>
<input type="hidden" name="que_17" value="Parking area">
<input type="hidden" name="service_17" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_17" id="yes_17">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_18"> Heavy equipment </span>
<input type="hidden" name="que_18" value="Heavy equipment">
<input type="hidden" name="service_18" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_18" id="yes_18">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_19"> Walkway/sidewalk </span>
<input type="hidden" name="que_19" value="Walkway/sidewalk">
<input type="hidden" name="service_19" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_19" id="yes_19">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_20"> Driveway </span>
<input type="hidden" name="que_20" value="Driveway">
<input type="hidden" name="service_20" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_20" id="yes_20">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_21"> Fencing </span>
<input type="hidden" name="que_21" value="Fencing">
<input type="hidden" name="service_21" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_21" id="yes_21">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_22"> Concrete </span>
<input type="hidden" name="que_22" value="Concrete">
<input type="hidden" name="service_22" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_22" id="yes_22">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_23"> Metal </span>
<input type="hidden" name="que_23" value="Metal">
<input type="hidden" name="service_23" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_23" id="yes_23">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_24"> Brick </span>
<input type="hidden" name="que_24" value="Brick">
<input type="hidden" name="service_24" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_24" id="yes_24">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_25"> Asphalt </span>
<input type="hidden" name="que_25" value="Asphalt">
<input type="hidden" name="service_25" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_25" id="yes_25">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_26"> Wood </span>
<input type="hidden" name="que_26" value="Wood">
<input type="hidden" name="service_26" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_26" id="yes_26">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_27"> Stucco </span>
<input type="hidden" name="que_27" value="Stucco">
<input type="hidden" name="service_27" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_27" id="yes_27">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_28"> Stone </span>
<input type="hidden" name="que_28" value="Stone">
<input type="hidden" name="service_28" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_28" id="yes_28">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_29"> Prepare for painting </span>
<input type="hidden" name="que_29" value="Prepare for painting">
<input type="hidden" name="service_29" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_29" id="yes_29">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_30"> Remove mineral or hard water deposits </span>
<input type="hidden" name="que_30" value="Remove mineral or hard water deposits">
<input type="hidden" name="service_30" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_30" id="yes_30">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_31"> Remove oil </span>
<input type="hidden" name="que_31" value="Remove oil">
<input type="hidden" name="service_31" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_31" id="yes_31">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_32"> Remove moss </span>
<input type="hidden" name="que_32" value="Remove moss">
<input type="hidden" name="service_32" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_32" id="yes_32">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_33"> Remove pollution and fuel emission residue </span>
<input type="hidden" name="que_33" value="Remove pollution and fuel emission residue">
<input type="hidden" name="service_33" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_33" id="yes_33">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_34"> Remove grease </span>
<input type="hidden" name="que_34" value="Remove grease">
<input type="hidden" name="service_34" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_34" id="yes_34">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_35"> Remove mold </span>
<input type="hidden" name="que_35" value="Remove mold">
<input type="hidden" name="service_35" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_35" id="yes_35">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_36"> Remove mildew </span>
<input type="hidden" name="que_36" value="Remove mildew">
<input type="hidden" name="service_36" value="Power Washing (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_36" id="yes_36">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div8">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_8"> Waste Management (check all that apply)</span>
</div>
<table>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div9">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_9"> Asphalt Sealcoating (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_37"> Driveway </span>
<input type="hidden" name="que_37" value="Driveway">
<input type="hidden" name="service_37" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_37" id="yes_37">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_38"> Patio </span>
<input type="hidden" name="que_38" value="Patio">
<input type="hidden" name="service_38" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_38" id="yes_38">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_39"> Parking lot </span>
<input type="hidden" name="que_39" value="Parking lot">
<input type="hidden" name="service_39" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_39" id="yes_39">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_40"> Walkway or sidewalk </span>
<input type="hidden" name="que_40" value=" Walkway or sidewalk">
<input type="hidden" name="service_40" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_40" id="yes_40">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_41"> Game court (tennis, basketball, etc.) </span>
<input type="hidden" name="que_41" value="Game court (tennis, basketball, etc.)">
<input type="hidden" name="service_41" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_41" id="yes_41">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_42"> Road </span>
<input type="hidden" name="que_42" value="Road">
<input type="hidden" name="service_42" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_42" id="yes_42">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_43"> Fill cracks </span>
<input type="hidden" name="que_43" value="Fill cracks">
<input type="hidden" name="service_43" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_43" id="yes_43">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_44"> Special coloring </span>
<input type="hidden" name="que_44" value="Special coloring">
<input type="hidden" name="service_44" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_44" id="yes_44">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_45"> Fill small potholes </span>
<input type="hidden" name="que_45" value="Fill small potholes">
<input type="hidden" name="service_45" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_45" id="yes_45">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_46"> Lines or markings </span>
<input type="hidden" name="que_46" value="Lines or markings">
<input type="hidden" name="service_46" value="Asphalt Sealcoating (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_46" id="yes_46">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div10">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_10"> Line Striping (check all that apply)</span>
</div>
<table>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div11">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_11"> Water Damage (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_47"> Do you need immediate emergency response? </span>
<input type="hidden" name="que_47" value="Do you need immediate emergency response? ">
<input type="hidden" name="service_47" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_47" id="yes_47">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_48"> Do you have flood damage? </span>
<input type="hidden" name="que_48" value="Do you have flood damage?">
<input type="hidden" name="service_48" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_48" id="yes_48">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_49"> Do you need an immediate evaluation of problem? </span>
<input type="hidden" name="que_49" value="Do you need an immediate evaluation of problem?">
<input type="hidden" name="service_49" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_49" id="yes_49">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_50"> Do you smell or see mold or mildew? </span>
<input type="hidden" name="que_50" value="Do you smell or see mold or mildew?">
<input type="hidden" name="service_50" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_50" id="yes_50">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_51"> Do you need sewage cleanup? </span>
<input type="hidden" name="que_51" value="Do you need sewage cleanup?">
<input type="hidden" name="service_51" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_51" id="yes_51">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_52"> Do you need your roof tarped? </span>
<input type="hidden" name="que_52" value="Do you need your roof tarped?">
<input type="hidden" name="service_52" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_52" id="yes_52">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_53"> Basement is flooded </span>
<input type="hidden" name="que_53" value="Basement is flooded">
<input type="hidden" name="service_53" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_53" id="yes_53">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_54"> Building materials are wet </span>
<input type="hidden" name="que_54" value="Building materials are wet">
<input type="hidden" name="service_54" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_54" id="yes_54">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_55"> Main or upper floor is flooded </span>
<input type="hidden" name="que_55" value="Main or upper floor is flooded">
<input type="hidden" name="service_55" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_55" id="yes_55">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_56"> Carpet and floors are damp </span>
<input type="hidden" name="que_56" value="Carpet and floors are damp">
<input type="hidden" name="service_56" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_56" id="yes_56">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_57"> Other </span>
<input type="hidden" name="que_57" value="Other">
<input type="hidden" name="service_57" value="Water Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_57" id="yes_57">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div12">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_12"> Fire Damage (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_58"> Needed fire damage restoration </span>
<input type="hidden" name="que_58" value="Needed fire damage restoration">
<input type="hidden" name="service_58" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_58" id="yes_58">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_59"> Need a board up? </span>
<input type="hidden" name="que_59" value="Need a board up?">
<input type="hidden" name="service_59" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_59" id="yes_59">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_60"> Need our roof tarped? </span>
<input type="hidden" name="que_60" value="Need our roof tarped?">
<input type="hidden" name="service_60" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_60" id="yes_60">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_61"> Need immediate emergency response? </span>
<input type="hidden" name="que_61" value="Need immediate emergency response? ">
<input type="hidden" name="service_61" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_61" id="yes_61">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_62"> Entire house or structure has burned down </span>
<input type="hidden" name="que_62" value="Entire house or structure has burned down">
<input type="hidden" name="service_62" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_62" id="yes_62">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_63"> A room was damaged </span>
<input type="hidden" name="que_63" value="A room was damaged">
<input type="hidden" name="service_63" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_63" id="yes_63">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_64"> Water damage from putting the fire out </span>
<input type="hidden" name="que_64" value="Water damage from putting the fire out">
<input type="hidden" name="service_64" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_64" id="yes_64">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_65"> A portion of the building has burned </span>
<input type="hidden" name="que_65" value="A portion of the building has burned">
<input type="hidden" name="service_65" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_65" id="yes_65">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_66"> Nothing burned but smoke has coated everything </span>
<input type="hidden" name="que_66" value="Nothing burned but smoke has coated everything">
<input type="hidden" name="service_66" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_66" id="yes_66">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_67"> Roof Affected </span>
<input type="hidden" name="que_67" value="Roof Affected">
<input type="hidden" name="service_67" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_67" id="yes_67">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_68"> Other </span>
<input type="hidden" name="que_68" value="Other">
<input type="hidden" name="service_68" value="Fire Damage (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_68" id="yes_68">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div15">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_15"> HVAC (check all that apply)</span>
</div>
<table>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div16">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_16"> Spring Clean Up (check all that apply)</span>
</div>
<table>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div17">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_17"> Handyman Service (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_69"> Repairs </span>
<input type="hidden" name="que_69" value="Repairs">
<input type="hidden" name="service_69" value="Handyman Service (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_69" id="yes_69">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_70"> Assembly </span>
<input type="hidden" name="que_70" value="Assembly">
<input type="hidden" name="service_70" value="Handyman Service (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_70" id="yes_70">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_71"> Installation </span>
<input type="hidden" name="que_71" value="Installation">
<input type="hidden" name="service_71" value="Handyman Service (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_71" id="yes_71">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_72"> Maintenance </span>
<input type="hidden" name="que_72" value="Maintenance">
<input type="hidden" name="service_72" value="Handyman Service (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_72" id="yes_72">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_73"> A variety of projects </span>
<input type="hidden" name="que_73" value="A variety of projects">
<input type="hidden" name="service_73" value="Handyman Service (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_73" id="yes_73">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_74"> Single project </span>
<input type="hidden" name="que_74" value="Single project">
<input type="hidden" name="service_74" value="Handyman Service (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_74" id="yes_74">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div18">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_18"> Painting (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_75"> Interior </span>
<input type="hidden" name="que_75" value="Interior">
<input type="hidden" name="service_75" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_75" id="yes_75">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_76"> Exterior </span>
<input type="hidden" name="que_76" value="Exterior">
<input type="hidden" name="service_76" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_76" id="yes_76">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_77"> Urgent: Looking for help as soon as possible </span>
<input type="hidden" name="que_77" value="Urgent: Looking for help as soon as possible">
<input type="hidden" name="service_77" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_77" id="yes_77">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_78"> Quotes: Looking for quotes on this project </span>
<input type="hidden" name="que_78" value="Quotes: Looking for quotes on this project">
<input type="hidden" name="service_78" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_78" id="yes_78">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_79"> Consultation: Looking to discuss my options </span>
<input type="hidden" name="que_79" value="Consultation: Looking to discuss my options">
<input type="hidden" name="service_79" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_79" id="yes_79">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_80"> Information: Looking to educate myself </span>
<input type="hidden" name="que_80" value="Information: Looking to educate myself">
<input type="hidden" name="service_80" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_80" id="yes_80">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_81"> New Construction </span>
<input type="hidden" name="que_81" value="New Construction">
<input type="hidden" name="service_81" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_81" id="yes_81">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_82"> Restain </span>
<input type="hidden" name="que_82" value="Restain">
<input type="hidden" name="service_82" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_82" id="yes_82">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_83"> One story </span>
<input type="hidden" name="que_83" value="One story">
<input type="hidden" name="service_83" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_83" id="yes_83">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_84"> Two stories </span>
<input type="hidden" name="que_84" value="Two stories">
<input type="hidden" name="service_84" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_84" id="yes_84">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_85"> Three stories or more </span>
<input type="hidden" name="que_85" value="Three stories or more">
<input type="hidden" name="service_85" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_85" id="yes_85">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_86"> Siding </span>
<input type="hidden" name="que_86" value="Siding">
<input type="hidden" name="service_86" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_86" id="yes_86">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_87"> Doors </span>
<input type="hidden" name="que_87" value="Doors">
<input type="hidden" name="service_87" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_87" id="yes_87">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_88"> Shutters </span>
<input type="hidden" name="que_88" value="Shutters">
<input type="hidden" name="service_88" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_88" id="yes_88">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_89"> Trim </span>
<input type="hidden" name="que_89" value="Trim">
<input type="hidden" name="service_89" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_89" id="yes_89">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_90"> Stucco </span>
<input type="hidden" name="que_90" value="Stucco">
<input type="hidden" name="service_90" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_90" id="yes_90">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_91"> Masonry (brick/stone) </span>
<input type="hidden" name="que_91" value="Masonry (brick/stone)">
<input type="hidden" name="service_91" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_91" id="yes_91">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_92"> Peeling or flaking paint </span>
<input type="hidden" name="que_92" value=" Peeling or flaking paint">
<input type="hidden" name="service_92" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_92" id="yes_92">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_93"> Chalking </span>
<input type="hidden" name="que_93" value="Chalking">
<input type="hidden" name="service_93" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_93" id="yes_93">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_94"> Chipped stucco </span>
<input type="hidden" name="que_94" value="Chipped stucco">
<input type="hidden" name="service_94" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_94" id="yes_94">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_95"> Trim pulling away from house </span>
<input type="hidden" name="que_95" value=" Trim pulling away from house">
<input type="hidden" name="service_95" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_95" id="yes_95">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_96"> Bare wood </span>
<input type="hidden" name="que_96" value="Bare wood">
<input type="hidden" name="service_96" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_96" id="yes_96">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_97"> Cracks </span>
<input type="hidden" name="que_97" value="Cracks">
<input type="hidden" name="service_97" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_97" id="yes_97">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_98"> Rusty nails </span>
<input type="hidden" name="que_98" value="Rusty nails">
<input type="hidden" name="service_98" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_98" id="yes_98">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_99"> Water damage </span>
<input type="hidden" name="que_99" value="Water damage">
<input type="hidden" name="service_99" value="Painting (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_99" id="yes_99">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div19">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_19"> Roof (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_100"> Water leaking into building </span>
<input type="hidden" name="que_100" value="Water leaking into building">
<input type="hidden" name="service_100" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_100" id="yes_100">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_101"> Blistering/cracking </span>
<input type="hidden" name="que_101" value="Blistering/cracking">
<input type="hidden" name="service_101" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_101" id="yes_101">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_102"> Water stains on ceiling </span>
<input type="hidden" name="que_102" value="Water stains on ceiling">
<input type="hidden" name="service_102" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_102" id="yes_102">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_103"> Water standing on roof after 48 hours </span>
<input type="hidden" name="que_103" value="Water standing on roof after 48 hours">
<input type="hidden" name="service_103" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_103" id="yes_103">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_104"> Icicles/Ice dams at edge of roof </span>
<input type="hidden" name="que_104" value="Icicles/Ice dams at edge of roof">
<input type="hidden" name="service_104" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_104" id="yes_104">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_105"> Roof is sagging </span>
<input type="hidden" name="que_105" value="Roof is sagging">
<input type="hidden" name="service_105" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_105" id="yes_105">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_106"> Broken or rusted flashing </span>
<input type="hidden" name="que_106" value=" Broken or rusted flashing">
<input type="hidden" name="service_106" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_106" id="yes_106">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_107"> Built up/"tar and gravel" </span>
<input type="hidden" name="que_107" value="Built up/"tar and gravel"">
<input type="hidden" name="service_107" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_107" id="yes_107">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_108"> Sprayed Polyurethane Foam </span>
<input type="hidden" name="que_108" value="Sprayed Polyurethane Foam">
<input type="hidden" name="service_108" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_108" id="yes_108">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_109"> Single Ply Rubberized </span>
<input type="hidden" name="que_109" value="Single Ply Rubberized">
<input type="hidden" name="service_109" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_109" id="yes_109">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_110"> Rolled/torch applied </span>
<input type="hidden" name="que_110" value=" Rolled/torch applied">
<input type="hidden" name="service_110" value="Roof (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_110" id="yes_110">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div20">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_20"> Electrical (check all that apply) </span>
</div>
<table>
</table>
</div>
</td>
</tr>
<tr>
<td>
<div style="display:none;" id="div21">
<div style="background-color:Yellow;height:20px;font-weight:bold;width:450px;">
<span id="service_21"> Exterior Restoration (check all that apply)</span>
</div>
<table>
<tbody>
<tr>
<td align="left">
<span id="que_111"> Masonry Repair </span>
<input type="hidden" name="que_111" value="Masonry Repair">
<input type="hidden" name="service_111" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_111" id="yes_111">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_112"> Waterproofing </span>
<input type="hidden" name="que_112" value="Waterproofing">
<input type="hidden" name="service_112" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_112" id="yes_112">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_113"> Caulking </span>
<input type="hidden" name="que_113" value="Caulking">
<input type="hidden" name="service_113" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_113" id="yes_113">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_114"> Expansion Joints </span>
<input type="hidden" name="que_114" value="Expansion Joints">
<input type="hidden" name="service_114" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_114" id="yes_114">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_115"> Parking Garage Restoration </span>
<input type="hidden" name="que_115" value="Parking Garage Restoration">
<input type="hidden" name="service_115" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_115" id="yes_115">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_116"> Balcony Repair </span>
<input type="hidden" name="que_116" value="Balcony Repair">
<input type="hidden" name="service_116" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_116" id="yes_116">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_117"> Elastomeric Coatings </span>
<input type="hidden" name="que_117" value="Elastomeric Coatings">
<input type="hidden" name="service_117" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_117" id="yes_117">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_118"> Traffic Bearing Coatings </span>
<input type="hidden" name="que_118" value="Traffic Bearing Coatings">
<input type="hidden" name="service_118" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_118" id="yes_118">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_119"> Facade Cleaning & Sealing </span>
<input type="hidden" name="que_119" value="Facade Cleaning & Sealing">
<input type="hidden" name="service_119" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_119" id="yes_119">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_120"> Below Grade Waterproofing </span>
<input type="hidden" name="que_120" value="Below Grade Waterproofing">
<input type="hidden" name="service_120" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_120" id="yes_120">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_121"> Building Evaluation and Inspections </span>
<input type="hidden" name="que_121" value="Building Evaluation and Inspections">
<input type="hidden" name="service_121" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_121" id="yes_121">Yes
</td>
</tr>
<tr>
<td align="left">
<span id="que_122"> Budgetary Proposals </span>
<input type="hidden" name="que_122" value="Budgetary Proposals">
<input type="hidden" name="service_122" value="Exterior Restoration (check all that apply)">
</td>
<td align="left">
<input type="radio" value="yes" name="queAns_122" id="yes_122">Yes
</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
<tr>
<td colspan="2" align="right">
<input type="button" id="btnBack1" name="btnBack1" value="BACK" class="btn-submit"> <input type="submit" id="btnNext3" name="btnNext2" value="Submit Request" class="btn-submit">
</td>
</tr>
</tbody>
</table>
</div>
</section>
<aside class="panel">
<section>
<h2>Customer Quote</h2>
<div id="my_quote" class="innerfade" style="position: relative; height: 209px;">
<li style="z-index: 4; position: absolute; display: list-item;">"We 've used Omni Snow Removal for the past three years and their service is excecllect." <cite> Alvin Trumbone <br> Aldi Inc. </cite>
</li>
<li style="z-index: 3; position: absolute; display: none;">"I Need My Shopping center cleared in a timely fashion.Year after year Omni provides a great service, and they get the job done fast " <cite> Frank Ullman <br> Brentway
Mangement <br> LLc </cite>
</li>
<li style="z-index: 2; position: absolute; display: none;">"We have a combination of 78 commercial and industrial locations across the US and they proactive and are on point in servicing our sites. I am proud to be a referral for Omni
as they have been servicing our sites since 2010." <cite> Joe Cullen (Chief Engineer) joe.cullen@engineer.com<br> United Systems </cite>
</li>
<li style="z-index: 1; position: absolute; display: none;">"We've used Omni for 4 years now and thay're an excellent service. they clean up vary well and they're always on time. I would recommend them to anyone looking for a snow
removal service" <cite> Barbara Corvo<br> Dion-segal Associates </cite>
</li>
</div>
</section>
<section>
<div class="yellow-box acenter">
<h2>Request a Quote</h2>
<a href="/RequestaQuote" class="btn">Click Here</a>
</div>
<br>
<div class="yellow-box acenter">
<h4>Become a Service Provider</h4>
<a href="/BecomeaServiceProvider" class="btn">Click Here</a>
</div>
</section>
</aside>
</div>
</div>
</article>
</form>Text Content
× Sorry, We don't perform residential services. Toll Free : 855-900-OMNI (6664) info@omnipropertyservices.com PROPERTY SERVICES * Home * About us * References * Weather Links * Contact Us REQUEST A QUOTE Contact Info Business Name: *This field is required. Title: Choose a title... Account Executive Account Representative Accountant Accounts Payable Accounts Receivable Acquisitions Analyst Acquisitions Associate Administrative Assistant Advertising Asset Manager Assistant Maintenance Manager Assistant Manager Associate Broker Associate Manager Asst. General Manager Asst. Manager Asst. Property Mgr. Asst. Vice President Asst. VP Specialty Leasing Broker Business Manager Center Manager Chairman Chairman of The Board Chief Executive Officer (CEO) Chief Financial Officer (CFO) Chief Information Officer Chief Operating Officer (COO) Co-Chairman Commercial Associate Commercial Project Manager Computer Programmer Consultant Controller Developer Development Manager Dir of Leasing/Comm. Ctrs Director Director of Acquisitions Director of Asset Mgmt. Director of Brokerage Services Director of Comm. Real Estate Director of Commercial Leasing Director of Corporate Comm. Director of Development Director of Leasing Director of Mgmt. Services Director of Operations Director of Properties Director of Property Mgmt. Director of Real Estate Director of Retail Leasing Director of Retail Properties Director of Sales District Manager Doctor Engineer Estimator Exec. Director Exec. Vice President Exec. VP Acquisitions Exec. VP Asset Management Exec. VP Center Mgmt. Exec. VP Development Exec. VP Finance Exec. VP Leasing Exec. VP Marketing Facilities Director Facilities Manager Facilities Supervisor Finance Director Finance Manager Financial Administrator Financial Consultant General Counsel General Manager General Partner Head of DMV Ice Ctl Chief Internet Services IT Consultant Lawyer Lease Administrator Leasing Agent Leasing Director Leasing Manager Leasing Specialist Maintenance Supervisor Manager Managing Agent Managing Director Managing Partner Marketing Marketing Director Marketing Manager Merchant Manager Miscellaneous MOD Mortgage Broker Night Operations Manager Office Manager Officer Operations Director Operations Engineer Operations Manager Owner Owners Wife Partner Planner Plow Chief Portfolio Manager President Principal Product Manager Project Director Project Manager Property Manager Property Services Director Real Estate Manager Realtor Regional Director Regional Manager Regional Property Manager Regional Vice President Research Director Retail Group Retail Leasing Manager Retail Properties Associates Retail Specialist Sales Sales Associate & Appraiser Secretary Secretary & Treasurer Senior Operations Manager Senior Project Manager Shovel Chief Site Manager Special Events Director Sr. Associate Sr. Leasing Agent Sr. Leasing Director Sr. Leasing Executive Sr. Project Manager Sr. Property Manager Sr. Vice President Sr. VP Acquisitions Sr. VP Asset Mgmt. Sr. VP Development Sr. VP Finance Sr. VP Leasing Sr. VP Management Sr. VP Marketing Sr. VP Operations Sr. VP Retail Sr. VP Retail Leasing Supervisor Tax Assessor Tech Treasurer Trustee Vice Chairman Vice President VP Acquisitions VP Asset Management VP Commercial Properties VP Commercial Services VP Construction VP Corp. Rel. & Mktg. VP Development VP Finance VP Lease/Mgmt. VP Leasing VP Management VP Marketing VP Operations VP Property Mgmt. VP Real Estate VP Retail VP Shopping Centers VP/Construction Website Designer First Name: *This field is required. Last Name: *This field is required. Address: City: State: Choose A State Alberta Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Ontario Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Zip: Email: The Email field is required. Work Phone: - - ext. Home Phone: - - Cell Phone: - - Fax: - - Comments Comments: Please double-check to make sure Required Fields have been filled out. Forms submitted without the Required information will not be processed. Job site info Job site address: Job site city: Job site state: Choose a State... Alberta Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Ontario Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Job site zip: Company Web Site: Site info What services are you interested in? Snow Removal (check all that apply) Power Sweeping (check all that apply) Power Washing (check all that apply) Waste Management (check all that apply) Asphalt Sealcoating (check all that apply) Line Striping (check all that apply) Water Damage (check all that apply) Fire Damage (check all that apply) HVAC (check all that apply) Spring Clean Up (check all that apply) Handyman Service (check all that apply) Painting (check all that apply) Roof (check all that apply) Electrical (check all that apply) Exterior Restoration (check all that apply) Other: If this is a large site, may we store equipment on-site? yes no Are you satisfied with your current level of service? yes no May we have the name of your current contractor? When is the best time to call? How many parking spaces are at this location(if any)? Requested Service Questions Snow Removal (check all that apply) We require sidewalk snow removal Yes We require ice control on parking lot areas Yes If a large site, may we store equipment at site Yes Are you satisfied with your current service? Yes We can provide bid specifications Yes Other Yes Roof Yes Commercial Yes Industrial Yes Power Sweeping (check all that apply) Are you interested in power sweeping services? Yes We have schematics or site plans Yes We can provide bid specifications Yes We need day porter services Yes Other Yes We need litter patrol Yes Power Washing (check all that apply) Side of building Yes Patio or deck Yes Parking area Yes Heavy equipment Yes Walkway/sidewalk Yes Driveway Yes Fencing Yes Concrete Yes Metal Yes Brick Yes Asphalt Yes Wood Yes Stucco Yes Stone Yes Prepare for painting Yes Remove mineral or hard water deposits Yes Remove oil Yes Remove moss Yes Remove pollution and fuel emission residue Yes Remove grease Yes Remove mold Yes Remove mildew Yes Waste Management (check all that apply) Asphalt Sealcoating (check all that apply) Driveway Yes Patio Yes Parking lot Yes Walkway or sidewalk Yes Game court (tennis, basketball, etc.) Yes Road Yes Fill cracks Yes Special coloring Yes Fill small potholes Yes Lines or markings Yes Line Striping (check all that apply) Water Damage (check all that apply) Do you need immediate emergency response? Yes Do you have flood damage? Yes Do you need an immediate evaluation of problem? Yes Do you smell or see mold or mildew? Yes Do you need sewage cleanup? Yes Do you need your roof tarped? Yes Basement is flooded Yes Building materials are wet Yes Main or upper floor is flooded Yes Carpet and floors are damp Yes Other Yes Fire Damage (check all that apply) Needed fire damage restoration Yes Need a board up? Yes Need our roof tarped? Yes Need immediate emergency response? Yes Entire house or structure has burned down Yes A room was damaged Yes Water damage from putting the fire out Yes A portion of the building has burned Yes Nothing burned but smoke has coated everything Yes Roof Affected Yes Other Yes HVAC (check all that apply) Spring Clean Up (check all that apply) Handyman Service (check all that apply) Repairs Yes Assembly Yes Installation Yes Maintenance Yes A variety of projects Yes Single project Yes Painting (check all that apply) Interior Yes Exterior Yes Urgent: Looking for help as soon as possible Yes Quotes: Looking for quotes on this project Yes Consultation: Looking to discuss my options Yes Information: Looking to educate myself Yes New Construction Yes Restain Yes One story Yes Two stories Yes Three stories or more Yes Siding Yes Doors Yes Shutters Yes Trim Yes Stucco Yes Masonry (brick/stone) Yes Peeling or flaking paint Yes Chalking Yes Chipped stucco Yes Trim pulling away from house Yes Bare wood Yes Cracks Yes Rusty nails Yes Water damage Yes Roof (check all that apply) Water leaking into building Yes Blistering/cracking Yes Water stains on ceiling Yes Water standing on roof after 48 hours Yes Icicles/Ice dams at edge of roof Yes Roof is sagging Yes Broken or rusted flashing Yes Built up/"tar and gravel" Yes Sprayed Polyurethane Foam Yes Single Ply Rubberized Yes Rolled/torch applied Yes Electrical (check all that apply) Exterior Restoration (check all that apply) Masonry Repair Yes Waterproofing Yes Caulking Yes Expansion Joints Yes Parking Garage Restoration Yes Balcony Repair Yes Elastomeric Coatings Yes Traffic Bearing Coatings Yes Facade Cleaning & Sealing Yes Below Grade Waterproofing Yes Building Evaluation and Inspections Yes Budgetary Proposals Yes CUSTOMER QUOTE "We 've used Omni Snow Removal for the past three years and their service is excecllect." Alvin Trumbone Aldi Inc. "I Need My Shopping center cleared in a timely fashion.Year after year Omni provides a great service, and they get the job done fast " Frank Ullman Brentway Mangement LLc "We have a combination of 78 commercial and industrial locations across the US and they proactive and are on point in servicing our sites. I am proud to be a referral for Omni as they have been servicing our sites since 2010." Joe Cullen (Chief Engineer) joe.cullen@engineer.com United Systems "We've used Omni for 4 years now and thay're an excellent service. they clean up vary well and they're always on time. I would recommend them to anyone looking for a snow removal service" Barbara Corvo Dion-segal Associates REQUEST A QUOTE Click Here BECOME A SERVICE PROVIDER Click Here LINK Home | About Us | References | Weather Links | Contact Us | Request a Quote | Become a Service Provider|Service Provider Login Copyright © 2004-2019 Omnisolutionsusa.com. 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