New Client Information Form You will not receive services until this form is completed and returned to usName(Required) Business Name(Required) Business Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Business Type(Required)Individual/Sole ProprietorCorporationPartnershipOtherOther Business Type, please specify(Required) Do you need an COI(Required) YES NO certificate of insuranceDo you need a W-9(Required) YES NO Tax ID Your businesses tax identification number.Website Address Job / Location Site InformationSite of Job / Location Name(Required) On-Site Contact(Required) Cell / Main Phone(Required)Billing InformationPO Job No. Billing Contact(Required) Office PhoneFaxEmail(Required) Business Address same as Billing Address?(Required) Yes No How would you like the invoices sent?(Required) Please email invoices Please mail invoices Please mail and email invoices Send Invoices to this Email(Required) Billing Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Comprehensive Security, Inc PoliciesCheck to Agree(Required) 4 hour minimum: Any job less than 4 hours is subject to a 4 hour charge.Check to Agree(Required) 1 hour cancelation policy: Any job canceled less than 1 hour before scheduled start time is subject to the 4 hour minimum charge.Check to Agree(Required) 24 hour cancelation required for barricades, cones, signs and any other type of equipment delivered to your job site.Check to Agree(Required) No show policy: Any job where an officer arrives for a scheduled job but the client appears not to arrive, the 4 hour minimum charge will apply.Check to Agree(Required) Payment is due no later than 30 days after services rendered.Check to Agree(Required) Holiday Fee applies to the following holidays: New Years Day, Memorial Day, July 4th, Labor Day, Thanksgiving, Christmas DayCheck to Agree(Required) In the event Client fails to tender payment within said 30 days, Client acknowledges that the outstanding balance shall accrue interest at the rate of 18% per annum until paid in full. In the event Comprehensive Security engages in collection attempts in pursuit of a delinquent balance, Client acknowledges that Client shall be responsible for all costs of collection, including attorneys’ fees and costs incurred by Comprehensive Security.Signature(Required)Name(Required) Title(Required) Δ
