New Client
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Client Service Request
New Client
Complete this form to request skilled personnel or services. Fields marked with
*
are required.
A. Company & Contact Information
Company or organization name
*
Primary contact phone
*
Secondary contact phone
Contact email
Number of personnel required
Preferred payment terms
Select payment terms
Pre-payment
post-completion
B. Service Requirements & Schedule
Desired services
*
Select desired services
Carpenter
Electrician
Mason
Painter
Plumber
Welder
Clear
Done
Select one or more services. Your selections will appear above.
Requested start date
Expected end date
Work description / scope
C. Location & Access Details
Region
*
Select region
BCC
CRR
KMC
LRR
NBR
NON
URR
WCR
District
*
Select district
Village / Town
*
Select village or town
Google latitude
Google longitude
Google Maps link
D. Site Conditions & Logistics
Site conditions / risks
Health & safety requirements
Equipment provided by client
Equipment required from Safando
E. Additional Notes & Compliance
Special requests / instructions
Additional notes
Liability insurance acknowledgement
Select an option
Yes
No
Liability insurance details
Clear form
Submit request