Service Request
CONTACT INFORMATION:
Requestor name:
*
Requestor Email:
Customer Name
*
Store Number or site number
Address:
*
City
*
State
*
Zip
Customer Contact
Contact e-mail:
*
Area code:
*
Phone number
*
SERVICE REQUIREMENT:
Date of request:
-
Month
-
Day
Year
Date
Service type:
Please Select
HVAC
Refrigeration
Plumbing
Electrical
Other
PO or work order #:
Is this a contract job
Yes
No
What is the contract number?
What is the NTE?
Location:
Please Select
1st floor
2nd floor or above
Kitchen
Loading dock / Back room
Lobby
Parking lot /garage
Pharmacy
Rest rooms
Roof
Sales floor
Warehouse
Other
Roof Height
Roof Access
Description of problem:
*
Urgency level:
Please Select
4 hours
Same day
Next day
Non priority
Other
If necessary, over time approved?
Yes
No
Overtime is time on site between 5 pm and 7 am
Account Manager
Please Select
Andrew Cohoat - acohoat@deemfirst.com
Kevin Kincaid - kkincaid@deemfirst.com
Tom Prather - tprather@deemfirst.com
Kent Shonborn - kshonborn@deemfirst.com
Pam Smith - psmith@deemfirst.com
Unknown
Other
Account Coordinator
Please Select
Amber Riggers - ARiggers@DEEMFIRST.com
Angela Laque - ALaque@DEEMFIRST.com
Blaine Tebbe - BTebbe@DEEMFIRST.com
Chasity Ray - CRay@DEEMFIRST.com
Christin Mahurin - CMahurin@DEEMFIRST.com
Ernie Schamber - ESchamber@DEEMFIRST.com
Esme Tebbe - ETebbe@DEEMFIRST.com
Karen Gladstone - KGladstone@DEEMFIRST.com
Keri Gilbert - KGilbert@DEEMFIRST.com
Laquisha Beck - LBeck@DEEMFIRST.com
Mary Eaton - MEaton@DEEMFIRST.com
Megan Widner - MWidner@DEEMFIRST.com
Renee Werner-Eppert - RWernerEppert@DEEMFIRST.com
Rick Zieles - RZieles@DEEMFIRST.com
Stacy Walker - SWalker@DEEMFIRST.com
Stacy Foster - SFoster@DEEMFIRST.com
Unknown
Other
THANK YOU:
You will receive a notification when your request has been processed. If you do not receive a notification within 10 minutes at your listed e-mail,
please call 866-288-2990.
Submit
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