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Thank you for your interest in partnering with Stout Imaging. We have been reimaging our nations retailers for over 100 years. We are looking for "Can Do" partners to join our team. Our goal is to leave all of our customers 100% satisfied, we can only accomplish this by having good people working for us. Please fill out the following application so we can contact you about working with us.

Everything you enter here will not be shared with anyone else, its sole purpose is gathering information to see if you are qualified to work with us.

  • Company:
    Contact:
    Title:
    Address:
    City:
    State:
    Zip:
    Phone:
    Fax:
    Mobile:
    Email:   
    How many years has your company been in business?
    Please check the box next to all the states you are currently licensed to do business in:





      
    Please check the box next to all the States in which you regularly work in:





    My Company carries the following insurance (Please check all that apply):
    General Liability:
    Worker Comp:
    Automobile:
    Umbrella:
    My company regularly performs the following functions with our own people (Please check all that apply):









    In performing work for your current customers what percentage do you sub-contract the work to someone else?
    Do your crews regularly use digital cameras?
    Do your crews have the ability to access the internet while they are traveling?
    My company owns/leases the following equipment (Please check all that apply):






    How many crews do you currently employ?
    What is the average time your supervisors have been with the company?
    Please list 5 of your most recent jobs including total revenue for the job:
     JobName Revenue
    Please list 3 customer references including contact info:
    Customer  ContactName Phone#
    Comments:
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