Application for U.S. Installers

This information is necessary for us to be able to correspond with you and provide you with the information that you requested. We will not release this information to any outside source and your information will be kept for contact purposes only.

CONTACT PERSON & TITLE

SOCIAL SECURITY NUMBER (SSN)

ORGANIZATION NAME


DAYTIME PHONE

FAX

E-MAIL ADDRESS

WEB PAGE ADDRESS

STREET ADDRESS OF MAIN OFFICE

ADDRESS

CITY

STATE / PROVINCE

POSTAL CODE / ZIP

        

ARE YOU CURRENTLY INSTALLING PLAYGROUND EQUIPMENT OR WORKING IN A RELATED INDUSTRY?
                         Yes              No

DESCRIBE YOUR CURRENT OPERATIONS:

HOW MANY YEARS HAVE YOU BEEN INVOLVED IN PLAYGROUND INSTALLATIONS?

OR

WHAT CONSTRUCTION EXPERIENCE DO YOU AND YOUR CREW HAVE?:

LIST ALL MANUFACTURERS / PRODUCT LINES THAT YOU HAVE PREVIOUSLY INSTALLED:

LIST ALL MANUFACTURERS / PRODUCT LINES THAT YOU CURRENTLY INSTALL:

ARE YOU CURRENTLY UNDER A CONTRACT WITH ANOTHER MANUFACTURER? IF SO, WHO?:

WHAT SIZE CREW DO YOU CURRENTLY EMPLOY?

1-3 3-5 5-7 7-11 11-15 15-20 20+

CURRENT INSTALLATION VOLUME / YEAR:

WHAT STATES / REGIONS / CITIES ARE YOU WILLING TO TRAVEL TO?

ARE YOU CPSI CERTIFIED?:YES    NO
IF YES, DATE COMPLETED:

HOW DO YOU PLAN TO WORK WITH THE CUSTOMER? (Communication, Consultation about playset layout, Inspections, etc).

WHAT DO YOU NORMALLY CHARGE FOR FULL INSTALLATION (percentage of retail playset cost or other?):

WILL YOU PROVIDE SUPERVISION OF INSTALLATIONS AS WELL? (supervising volunteer crew):   YES    NO

WHAT DO YOU NORMALLY CHARGE FOR A SUPERVISION?:

DO YOU OFFER INSTALLATION OF SURFACING?:   YES    NO
WHAT TYPES HAVE YOU HAD EXPERIENCE WITH?

ENGINEERED WOOD FIBER
POURED-IN-PLACE RUBBER
RUBBER TILE
SHREDDED RUBBER
OTHER, PLEASE SPECIFY    

WOULD YOU BE WILLING TO PARTICIPATE IN A FIRST-TIME TRAINING INSTALLATION?:  YES    NO

ARE YOU INTERESTED IN SELLING PLAYGROUND EQUIPMENT AS WELL?:  YES    NO
IF YES, COMMERCIAL AND / OR RESIDENTIAL

PREVIOUS JOB REFERENCES: (include name, address, phone & contact person)

   1.

   2.

   3.

COMMENTS:

Please send photos of installations and proof of CPSI certification if available. Reference letters may be included. Please email to dawn@playmart.com or mail to Play Mart, Inc. Attn: Dawn Beach 170 Allens Way Somerset, KY 42501.