National Accounts Division
Pre - Qualification Form
· For Internal Use Only – Not for Customer Viewing / Date:· Rate sheets for the customer in question must be submitted with this form.
· Incomplete forms and older form versions will be rejected.
Submitting Rep Information
NAD Rep Name: / Rep #: / LOC:
Customer Contact Information
Customer: / Phone #:
Address:
City: / State: / Zip:
Contact Name: / Title:
Customer Background Information
1. Did the customer request a national account? / Yes / No
2. Where are the headquarters for the customer located? / Same as above.
Address:
City: / State: / Zip:
3. Does the customer have a parent company? / Yes / No
Name of Parent Company:
Address:
City: / State: / Zip:
Comments
4. Does the customer have an account with Ahern Rentals now or have they had one in the past?
Yes / No
If “Yes” what is their primary account number?
5. What type(s) of work do they perform? (Ex. General Contractor, Mechanical Contractor, Glazing, Plumbing etc.)
Primary:
Secondary:
Additional:
6. What is the customer’s current annual rental spend with Ahern?
$ / annually
7. Select the states in which the customer (or parent company) currently works in and/or has locations, offices and facilities.
AZ / GA / LA / NV / NY / OK / SC / UT / FL
CA / IL / MD / NJ / NC / OR / TN / VA
CO / KS / NB / NM / ND / PA / TX / WA
8. What is the customer’s potential annual rental spend within the Ahern footprint?
$ / annually
9. Explain how pricing will be handled below
Comments
10. Does the customer require purchase orders? / Yes / No
11. Use the space below to explain any special arrangements, requirements, conditions or other types of information that may be important to know before proceeding with a national account.
Comments
* When completed, email form, rates and any other attachments to
LA # 16762 / © Ahern Rentals, Inc / Last Revised: 04/26/13