Service Application Application for servicers wishing to work on Lacanche ranges for Art Culinaire. Company Legal Name*Trade NameBusiness License #State(s)Mailing Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Shipping Address same as Mailing Address Shipping Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Other Address Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Main Phone*Other PhoneFaxText PhoneDate the business startedHow long at present locationOwner Name*Owner PhoneOwner Email* Owner Text PhoneService Contact*Service Phone*Service Email* Service Text PhoneAccounts Payable ContactAccounts Payable PhoneAccounts Payable Email Accounts Payable Text PhoneOwner preferred contact methodPhoneTextEmailService preferred contact methodPhoneTextEmailAccounting preferred contact methodPhoneTextEmailTotal EmployeesNumber of Service TechniciansNumber of Qualified ElectriciansNumber of Gas TechniciansUniformed EmployeesYesNoBackground Checks DoneYesNoDrug Tests DoneYesNoHow Many TrucksAre Trucks Logo/LetteredYesNoDo You Have an AirsledYesNoCommentsService InformationProducts Serviced Electric Ranges Gas Ranges Vent Hoods Products Installed Electric Ranges Gas Ranges Vent Hoods Brand Names ServicedBrand Names For Which Your Are CertifiedPrimary Areas/Cities/Counties/Zip Codes CoveredCoverage Determined ByService RadiusZip CodeArea of Coverage*15 mile radius25 mile radius50 mile radius Travel Outside Your Area How Far Do You Travel Outside Your AreaPreferred Courier For Receiving PartsUSPSUPSRatesRate structure*Flat feeHourlyRate* Minimum trip fee Trip Fee Mileage fee beyond certain distance Mileage fee and distance
