Dealer Info

 End User Info

* Name

Name

Sales Rep Name

* Location

* e-mail

   

* Phone

   

 Financial Info

Lease Type

Deal Comments

Monthly Payment

Lease Term

months

Expected Term

months

Equipment Cost

One-time Cost

Total Cost

 Specifications

Modular Need

Expected Completion

Teardown

Cost + %    List %
Prevailing Rate
Fixed Cost   - List cost

Return Frt

Cost + %    List %
Prevailing Rate
Fixed Cost - Amount

States Code

Floorplan

Occupancy

B- Business E -Education A -Assembly Other

Manufacturer

Qty /#floors

Box Module Sizes

Box Complex Size

Total Sq. Ft.

Value

X

X

X

X


Roof


EPDM  Galvanized  Shingled  Other

Exterior

T1-11   Aluminum   Steel ( GA ) Hardi Panel
Pleko/ Stucco Vinyl   Smart Panel  Other

Floor decking

5/8  3/4 Other

Floor finish

Tile  Carpet Other

HVAC

# Units Tons/Unit End Mount Roof Mount Pad Other

Frame

Steel Outrigger  Steel Perimeter  Concrete Sys  Other

Clear Span?

Yes   No

Electrical:

single phase three phase

Sprinkler

Yes   No

Handicapped

Yes No

Bath?

Yes   No