New Customer Application

Name: Campbell
Address: 90 Stanford Pkwy,, Findlay, OH, 45840

Thank you for inquiring about Campbell Mechanical Services. We look forward to serving you and discovering ways to optimize your commercial HVAC and mechanical systems.
Please fill out this form so we can get started.

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Legal Name of Business
Please enter your legal business name.
Business Type
Federal Tax ID#
Business Description / Industry
Principal / Partner / Officer / Name
Principal / Partner / Officer Title / Title
Principal / Partner / Officer Email
Please enter the principal's email address.

This isn't a valid email address.
Principal / Partner / Officer Phone
Please enter the principal's phone number.

This isn't a valid phone number.
Tax Exemption Status
If yes, Sales and Use tax exemption certificate is required
Please upload your exemption certificate.
Are you interested in receiving services in Northwest Ohio (Greater Toledo and Findlay Areas)?
Are you interested in receiving services in Northern Central Ohio (Greater Cleveland Area)?
Are you interested in receiving services in Southeast Michigan (Greater Ann Arbor Area)?
Service Site Name (If same as Legal Business Name, enter "Same")
Please enter the Service Site Name or "Same" if it matches your Legal Business Name.
Site Street Address

Please enter your site's street address.
Site Address City

Please enter your site's city.
Site Address State

Please enter your site's state.
Site Address Zip

Please enter your site's zip code.
If applicable please include an additional location address
Billing Address (Write "Same" if same as Site)

Please enter your site's Billing Address.
Accounts Payable Contact

Please enter your site's Account's Payable Contact.
Accounts Payable Email
Please enter your site's Account's Payable Email.

This isn't a valid email address.
Accounts Payable Phone
Please enter your site's Account's Payable Phone Number.

This isn't a valid phone number.
Does your organization require a Purchase Order to be on the invoice?
If yes, is the person to be contacted the same as the A/P contact listed above
If no, please provide the contact info where to send the invoice
Does your organization use an on-line invoicing system (i.e. Ariba, Epro, or Coupa)?
If yes, which one?
Service Site Contact (This contact information will be used to confirm your submission)
Please enter the Service Site Contact Information.
Service Site Email (This email address will be used to confirm your submission)
This isn't a valid email address.
Service Site Phone Number
Please enter the Service Site Phone Number.

This isn't a valid phone number.
How Did You Hear About Campbell Inc?
List any Campbell Employee(s) you have been in contact with:

Please enter any Campbell Employee or NA.
Describe any current Service Requests:
Does this application include at least 2 different email addresses and phone numbers?
Please indicate whether this application includes at least 2 different email addresses and phone numbers.
- Contact Name
  Please enter the additional contact's name.
- Contact Role / Title
  Please enter the additional contact's role.
- Contact Phone
  Please enter the additional contact's phone number.
  
  This isn't a valid phone number.
- Contact Email
  Please enter the additional contact's email address.
  
  This isn't a valid email address.
By checking this box, I agree to the Service Terms, Conditions, & Limitations*

Please opt in to submit.
By submitting, you agree to receive text messages from Campbell at the number provided, including those related to your inquiry, follow-ups, and review requests, via automated technology. Consent is not a condition of purchase. Msg & data rates may apply. Msg frequency may vary. Reply STOP to cancel or HELP for assistance. Acceptable Use Policy

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