Service Contact Person
Office Contact Person
After Hours Emergency Contact
Are you a member of a Union?
If yes, which Union?
Standard Business Hours
CCTV Hourly Rate:
Data Hourly Rate:
Telco Hourly Rate:
Fire & Burg Hourly Rate:
Low Voltage Hourly Rate:
Networking Hourly Rate:
Delayed Egress Hourly Rate:
Travel Distance Without Charge:
What metropolitan area(s) do you service?
Please check the services you are experienced with
Fire and Burglary
Attach copies of all licensing (doc, docx, pdf formats only):
Please include all copies of licensing if printing this application.
If Delayed Egress, number of technicians?
If Fire and Burglary, license number?
List any specific brands of programs/systems that you might be qualified in such as Bosch, Nortel, etc.?
How did you hear about Coliant Solutions?
Do you know anyone that currently works with us?
Thank you for interest, please scan and email with your licensing documentation to Kim.Barth@CoLiantSolutions.com or mail a copy with your licensing documentation to our corporate head quarters Attn:Kathy Brautigam, 2703 Brickton North Drive, Buford, GA 30518
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