PARTNER ENROLLMENT

Section I: General Information

Please answer every question. If you believe a question does not apply to you enter "N/A".

1) Do you currently have a signed nfrastructure Technet Agreement on file with us?
Yes     No
2) Information
Company Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone:
Fax:
Email:
Company Website:
Contact Person:
Title:
Fed. Tax ID#:
Dunn & Bradstreet #:
3) How is your business categorized for tax purposes?
S Corporation   LLC   C Corporation   Sole Prop./DBA
If Other, please specify:
4) Is your company classified as a small business enterprise, minority-owned or woman-owned business?
Yes     No
If yes, please identify the various types of certification granted to your firm (ie: 8a, Minority Business Enterprise, Local or State Government Office, etc.)
5) Have you previously worked with nfrastructure on any projects?
Yes     No
If yes, list customer(s) and location(s).
6) How long have you been in business?
7) Do you own or lease your business location?
Own     Rent
8) Square footage of building?
9) Is your building and/or warehouse area secured and monitored?
Yes     No
10) Please list your revenues:
2012 Expected Revenue:
2011 Revenue:
2010 Revenue:
If you are qualified and invited to be a partner, we will require further financial and credit information.
11) Where are your offices located?
12) In which cities are you capable of providing resources?
13) How may employees do you have?
No. of Staff:
No. of Consultants:
14) How are your employees classified?
W-2 Only     1099 Only
Mix of both (explain):
15) What is the size of your resource database that you would be able to schedule for assignments?
16) Do you have an available bench of resources to meet immediate project needs?
Yes     No
17) How did you find out about nfrastructure?

SECTION II: Proposed Services Rates

Please complete the following Resource Profile Summary as completely and accurately as possible, so that we may have a better sense of your company's geographic coverage as well as your technical consultants' educational and skill backgrounds. If you believe a question does not apply to you, enter "N/A".
1) Educational Certificates and Degrees of consultants (Select all that apply.)
A +   Network +   MCDST   MCSA   MCSE
 
Cisco (please indicate levels of Cisco certification(s) below)
Sun (please indicate levels of Sun certification(s) below)
2) Describe Tier 1, Tier 2 and Tier 3 and add pricing matrix for each tier.
Tier 1Tier 2Tier 3
Hourly Rate Service Level Hourly Rate Service Level Hourly Rate Service Level
Scheduled Scheduled Scheduled
2-4 Hour 2-4 Hour 2-4 Hour
4-8 Hour 4-8 Hour 4-8 Hour
Next Business Day Next Business Day Next Business Day
Off Hour Off Hour Off Hour
3) Please describe your travel policies.
-Indicate portal-to-customer location mileage
-Additional travel time hourly rate
4) List the top 3 industries supported by your firm. (e.g. manufacturer, scientific research & development, healthcare, communications, etc.)
1.
2.
3.
5) List your firm's top 3 core competencies, with "1" being the strongest and "3" being the weakest.
Technology deployment:
Structured cabling:
Break/Fix:
If "Other", please describe:
Core competencies descriptions: Please provide and overview.
6) Definition of Services (Please provide information that can be used to create a company profile of your firm):
7) Please include a brief description of your business that will be used to present your qualifications in proposals or other marketing material:

SECTION III: Additional Information

Please answer every question. If you believe a question does not apply to you, enter "N/A".
1) How do you currently market your services?
2) Do you have an outside sales team?
Yes no
3) What websites do you frequent for...
Job Opportunities?
IT Industry News?
Entertainment?
4) What professional organizations do you or your firm belong to?
5) References
Please list at least 3 professional references below.
Company Name 1:
Company Address 1:
Company Contact 1:
Company Phone 1:
Company Email 1:
Date of services last provided 1:
Company Name 2:
Company Address 2:
Company Contact 2:
Company Phone 2:
Company Email 2:
Date of services last provided 2:
Company Name 3:
Company Address 3:
Company Contact 3:
Company Phone 3:
Company Email 3:
Date of services last provided 3:


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