|
Name |
|
|
Address |
|
|
City |
|
|
State |
|
|
Zip |
|
|
Apt.# |
|
|
Cross Streets |
|
|
Home Phone |
|
|
Cell |
|
|
Work |
|
|
Email |
|
|
Fax |
|
|
Website |
|
|
Directions to your home |
|
|
Type of home |
|
|
Number of
Floors |
|
|
Rooms to be cleaned |
Bedrooms
Bathrooms
Living
Room
Kitchen
Hallways
Stairways
Gym
Attic
Garage
Playroom
Pet
Area
Basement
Office
Den
Laundry
Room
|
|
Floor Type |
Other
|
|
How Often |
other
|
|
Preferred days |
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.
Any
day
|
|
Preferred time |
7-11
11-2
2-5
5-8
pm
9-10
pm |
|
Cleaning Type |
|
|
Level of Cleaning & Hourly Rate |
|
|
Square Footage |
|
|
Numbers of bathrooms |
|
|
Tub or Slide in Door |
|
|
Clutter in bathrooms |
|
|
Numbers of bedrooms |
|
|
Floor's Condition
(select what applies to you) |
Paint
CementGlueMold
Other
|
|
Do you have a vacuum?
|
|
|
Do you need a vacuum?
(we currently have no vacuums available for drop offs)
|
|
|
Bring our supplies?
(supplies are not included in hourly
rate). Supplies |
Yes,
$23.00
No |
|
Cleaning supplies are included in
package rate,
however do you have any supplies in
your home? If so, please list. Supplies |
|
|
All appliances are
cleaned and polished on the outside, do you need the inside of the following
appliances cleaned? |
Additional Services; please select and list level of
cleaning, light, medium or heavy:
Fridge
light, medium or heavy?
Freezer
light, medium or heavy?
Freezer
ICS to defrost freezer? Yes or no
Stove
light, medium or heavy?
Microwave
light,
medium or heavy?
Dishwasher
light, medium or heavy?
Cabinets
light, medium or heavy?
Closets
light, medium or heavy?
Drawer
Organizing
small, medium or large pile
|
|
Other Additional Services |
Fireplace
Errands
Ceiling
Fans
Light
Fix.
Pet
Services
Dog
Walking
Groc.
Shopping
V
|
|
Cabinets;
are your cabinets white in color or wood?
|
|
|
Will the insides of the cabinets
be emptied? If items are not removed,
extra charges will apply for removal). |
|
|
Any other large additional mirrors or glass
surfaces to be cleaned? |
|
|
Do you have pets? If so, please
specify.
|
|
|
Excessive
pet hair? |
|
|
Does your building have a elevator/doorman?
|
|
|
How will we access your home?
|
You
Neighbor
Super
Doorman
Other |
|
Any clutter, explain
(clothes, books, laundry, etc. laying around
that may slow us down? small, medium, or large piles?
|
|
|
Do you want us to organize your
clutter?
Extra charge will apply |
|
|
Do you want a package or
hourly rate? If you are seeking medium - heavy duty cleaning please
select package rate. If you are seeking light cleaning please select hourly
rate. click here for explanation (Please scroll down
to view explanation). |
|
|
How did
you
hear
about us? |
Web
Google
MSN
Yahoo
AOL
The Cleaning
Services Directory
Business Card
Flyer
Courier
Life Newspaper
Referral
Word
of mouth
Other
|
|
Submit estimate to you by: |
Phone
Email
Fax |
|
How long did it take to complete this form?
|
|
|
Was completing this form easier than calling us? |
|
