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Independent Collision Repair Facility - Canada

	Facility Information
Facility Name (*)	Please enter your Facility Name.
Is your facility incorporated? (*)	Yes No Invalid Input
Is your facility owned by a dealership? (*)	Yes No Invalid Input
If yes, what is the dealership name?	Invalid Input
	Contact Information
Address (*)	Please enter your company Address.
City (*)	Please enter your company's City.
Province (*)	Please select your company's State.
Postal Code (*)	Please enter your company's Postal Code.
Telephone Number (*)	Please enter your telephone number.
Fax Number	Invalid Input
Email Address (*)	Please enter your Email Address.
Website
Contact Name (*)	Please enter the full name of someone to contact at this number.
Contact Title (*)	Please enter the title of the person who should be contacted.
Do you accept emailed assignments? (*)	Yes No Invalid Input
To what email address?	Please enter a valid Email Address.
	Facility Capabilities
Facility is capable of repairing Check all that apply (*)	Cars (Class 1-3) Light-Duty Trucks (Class 1-3) Medium-Duty Trucks (Class 4-6) Heavy-Duty Trucks (Class 7-8) Truck Body Box Truck Lift Gate Aerial Lifts Wheelchair Lifts Bus (Front) Bus (Rear) Semi-Tractor (18-Wheeler) Semi-Trailer (18-Wheeler) Aluminum Body Repairs Mechanical Repairs Refrigeration Please check at least one box regarding your inspection capabilities.
Spray booth for ALL types of abovereferenced vehicles?	Yes No Invalid Input
	Service Delivery Guarantees
Are you willing to pick up and deliver vehicles within a 25 kilometer radius? (*)	Yes No Invalid Input
Are you willing to contact our drivers within 24 hours of receiving an assignment? (*)	Yes No Invalid Input
Are you willing to go to the vehicle location to write an estimate? (*)	Yes No Invalid Input
Does your facility have an internet connection? (*)	Yes No Invalid Input
Are you willing to provide PHH Arval with a computer-generated estimate? (*)	Yes No Invalid Input
Can you provide an emailed copy of your estimate?	Yes No Invalid Input
What estimating format/formats does your shop use? Click while pressing the shift key to select more than one. (*)	Invalid Input
If other, please indicate	Invalid Input
Are you willing to download a software application onto your pc that allows transmission from your estimating system to PHH?	Yes No Invalid Input
Can you provide an emailed copy of your digital photos?	Yes No Invalid Input
What type of camera does your facility use for photographs? Click while pressing the shift key to select more than one. (*)	Invalid Input
If other, please indicate	Invalid Input
Are you willing to provide free towing? (*)	Yes No Invalid Input
Are you willing to work from a standard 30-day PO? (*)	Yes No Invalid Input
Are you willing to provide free storage for a period no longer than thirty (30) days? (*)	Yes No Invalid Input
Are you willing to provide PHH a processing fee from the bottom line of each invoice? (*)	Yes No Invalid Input
What paint types can your facility provide? e.g., BASF, Dupont, Sherwin Williams, etc.	Invalid Input
Can your facility replace decals/graphics without subletting?	Yes No Invalid Input
Is your business minority owned?	Yes No Invalid Input
Certified Technicians? Please check all that apply	ASE I-CAR I-CAR Gold I-CAR Platinum

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Service Delivery Guarantees