Wufoo

Company Name *
Contact Name * First Last
Contact Number * ### - ### - ####
Email *
Office Location (City/State)
You provide coverage area:
Coverage Area

Describe, in general, your coverage area. (State/County)
Do you currently work for a HUD Field Service Manager?
How many years of experience do you have providing HUD REO maintenance or inspection services? (Homes that have already conveyed to and are owned by HUD)
If yes, list all FSM's that you are currently providing services and how long you have worked for each:
List the volume you are providing by month, for each of the above services you are providing.
If you are not currently providing these services, have you provided HUD REO maintenance or inspection services in the past?
If yes, provide detail. (Who you worked for, how long, what services and volumes were provided)
What do you charge for the following HUD REO specific services:

Pre-Conveyance Inspection $ Dollars . Cents
Price listed should be per inspection
HUD HIPR Report (1,2 & 3) $ Dollars . Cents
Price listed should be per report. This price should include the report only. No securing or health and safety work should be included in this price.
HUD Initial Wipe Down & Vacuum $ Dollars . Cents
(includes basic dusting/wipe down, floors vacuumed & swept)
Routine Grass Cuts $ Dollars . Cents
Per grass cut up to 15,000sqft
Routine Inspection $ Dollars . Cents
Assume 10 min to complete with minimal photos.
Winterization $ Dollars . Cents
Do you currently package services together during a visit to the property? If so, what services do you package together and what is your cost to perform these bundled services at that visit?
Please provide 3 industry references. If you have provided services for FSM contractors, list them as your references:

Company reference #1
Is reference #1 a HUD FSM reference?

FSM = HUD Field Services Manager or HUD M&M
Refrence #1 Contact Name First Last
Refrence #1 Phone ### - ### - ####
Reference #2 Company Name
Is reference #2 a HUD FSM reference?

FSM = HUD Field Services Manager or HUD M&M
Reference #2 Contact Name First Last
Refrence #2 Number ### - ### - ####
Reference #3 Company Name
Is reference #3 a HUD FSM reference?

FSM = HUD Field Services Manager or HUD M&M
Reference #3 Contact Name First Last
Reference #3 Number ### - ### - ####
Please provide any additional information about your company (services/experience/capabilities) that will help us to better understand your service offering.
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