Internal Lead Form for Customer Care and Sales Associates

To submit a rental sale or lead, choose “Rentals”.

Required fields are marked with an asterisk (*).

Submitted by: *

What kind of lead is it? *

Contact's Name*

Company Name*

Phone Number*

Ext:

Email*

Address

City

State

Zip*

When is the best time to contact them?

How would they prefer to be contacted?

Lead Source (How did they find us?)*

Other source:

Product of interest

BuyGeneral Info

They'd like to schedule a demoThey'd like to request a quote

Tell us more about your planned application or any problem areas:

Where the buying decision will be made:

Where the product will be used:

Additional contact requests: Please have a sales person contact meRequest an on-site survey

Request additional information about:

Please type your comments and/or questions below:

Do you know the part number(s) you wish to order? YesNo

Bill To:

Same as above

Company Name*

Contact Name*

Address*

P.O. #

City*

State*

Zip*

Order Information

Make

Model

Serial Number

Order Parts:

Please input as much information as you know and we'll help you find the part you're looking for.

Machine Information:

Make

Model

Serial Number

Concerns / Comments

Lead is out of territory (or) Customer needs a survey (or) Customer is unsure if renting or buyingNone of the above

Which is it?* LEADSOLD

Do they have an account?

Machine Class*

Desired Scrub Type?

Desired Street Sweeper Type?

Should the sweeper be...Street legalAble to reach highway speeds

Make/Model of Requested Rental (if mentioned by customer)

Desired power source:

Do they need more LP?

Do they need chemical? *

On-site contact, if different from above:

Name

Phone

Ext.

Facility/Customer Type*

Estimated SqFt to be Cleaned

Type of Application/Job Site

Application Area

Floor/Surface Type

Approximate Amount of Debris

What type of debris is it?

Desired Delivery Date

Rental Term

Delivery Option

Special Instructions

Send me more informationContact me to schedule a free onsite demo

Additional contact requests:
Please have a sales person contact me

Request additional information about:
PartsServiceStreet SweepersSupplies

Please type your comments and/or questions below:

Please note: If you, somehow, managed to find this page and you’re not one of Bortek’s employees, you can simply ignore what’s here as it offers no value to you. We highly recommend checking out the content on these pages though!!

Internal Lead Submission Form

Internal Lead Form for Customer Care and Sales Associates

Required fields are marked with an asterisk (*).

Bill To:

Order Information

Machine Information:

Unit Information #1

Unit Information #2

Please note: If you, somehow, managed to find this page and you’re not one of Bortek’s employees, you can simply ignore what’s here as it offers no value to you. We highly recommend checking out the content on these pages though!!

EQUIPMENT PARTS RENTALS SERVICE SUPPLIES