NOTE:
PLEASE TYPE EVERYTHING EXACTLY AS YOU WANT IT TO APPEAR!

Contact Name:

Company Name:

Address: (Shop Address)

City, State, Zip:

Phone:

Fax:

E-mail address: (leave this blank if your company does not have one)

Web Page: (leave this blank if your company does not have one)

Estimating Ststem:
None/Not Available
CCC Infor. Systems
Mitchell
ADP
Others:

Paint Matching System:
None/Not Available
Akzo-Nobel
BASF
DuPont
Herberts Standox
ICI Autocolor
Martin Senour
PPG
Sherwin Williams
Spies Hecker
Valspar Sunbelt

I-Car Gold?
NO  YES

Written Warranty?
NO  YES

Association Membership:
None/Not Available
SCRS
ASA
CIC

Independent Franchise:
None/Not Available
CARSTAR
ABRA
Caliber Collision
MAACO
CARS
Others:

Frame/unitized Equipment:
None/Not Available
BlackHawk
Car-O-Liner
ChassisLiner
Cheetah
Cheif EZ-Liner
Duzmor
Hein Warner
Kansas Jack
Kar Grabber
Shark
Starliner
WedgeClamp
Others: