CUSTOMER INFORMATION - BID REQUEST FORM

 

REQUEST INFO         * Required
*  Request From:
Individual Home Owner  Dealership    Builder
If Dealership: Location:    Store #:
Salesman:
* Requester's E-Mail:
CUSTOMER INFO      * Required
Customer First Name(s):
* Customer Last Name:
Legal Address: Lot, Block & Subdivision
* Street Address:
* City:
* State:
* Zip:
* County or Parrish:
Customer E-mail Address:
* Phone:
Mobile Phone:
Other Phone:
* Loan Type: FHA  Cash Deal    Chattel Loan
Budget Amount: $
HOUSE INFO      * Required
*  Type: Manufactured Home    On-Frame Modular     Off-Frame Modular   
Manufacturer Name:
Model:
* Size: W   L
Number of Bedrooms:
Number of Bathrooms:
SCOPE OF WORK REQUIRED
EXCAVATION

Clear and Level Home Site
Debris Removal (Trees, dirt, demolition debris hauling to dump)
Fill Dirt Available On-Site. If checked, type of dirt
FOUNDATION

Dirt Pad Only
Concrete Cross Runners    w/perimeter (Louisiana requires perimeter)
ETE Runners (run the length of the house)    w/perimeter (Louisiana requires perimeter)
Full Slab
Pilings
Other (Specify)
Is property located in 100 yr. Flood Plain?     Yes    No
Wind Zone  1     2      3
DRIVEWAY
Driveway Material:  Concrete  Asphalt  Gravel  None  (If Checked Please indicate SIZE below)
Driveway size    W   L   +     W   L
Is Culvert Required?  If so, what size:   Length   Diameter
Is Permit Required?  Yes    No    If 'Yes' who has jurisdiction?  City   County  POA   State  
Name of Permitting Authority:
Parking Area Material:  Concrete  Asphalt  Gravel  None
Parking Area Size:     W   L   +    W   L
UTILITIES
WATER SERVICE
Existing Water Service.  Name of service provider: 
Requires New Water Tap.  Name of service provider: 
Include meter, tap or impact fee in estimate.
Existing Water Well.  If checked, what is the distance from well to home in feet: 
Requires New Water Well & Pump
FHA Water Test required by Lender?
SEWER/SEPTIC SERVICE
Existing Sewer Service.  Name of service provider: 
Requires New Sewer Tap.  Name of service provider: 
Include meter, tap or impact fee in estimate.
Grinder Pump & Tank required.
Existing Septic System*.  If checked, what is the distance from the septic tank to the home in feet: 
* FHA loans with existing septic systems must be inspected and approved.  Louisiana septic systems must have service agreement.
Pump and Inspect Existing Septic System
Requires replacing Existing Septic System (collapse and rebuild)
Requires New Septic System.  If checked what type disbursement system:  Conventional Field    Aerobic Disbursement
Septic System Permit Required.  If checked, name of permitting authority: 
ELECTRIC SERVICE
 
Name of Electric Service Provider: 
Include service fees in bid.
Requires Meter Loop
Existing Meter Loop.  If checked what is the current rating  100 amp    200 amp
A/C Disconnect Required
GAS SERVICE
 
Name of Gas Provider if applicable:
Include service fees in bid.
Existing natural gas line
Requires new natural gas line
Existing Propane Tank. If checked, does tank require moving  Yes    No
Requires Propane Tank
SKIRTING
THG STUCCO Skirting Systemâ„¢  - Trim cap style   Bullnose (rounded)    Bevel Edge (angular)
Rapid-Wall-System Vinyl Skirting  -   Color  White   Grey  Tan
Brick or Stone Skirting - Type of brick or stone 
STAIRS, DECKS, PATIOS & PATIO COVERS
Front Wood Stairs Only.
Front Wood Deck and Stairs.  If checked what size  W  
Front Concrete Patio and Stairs. If checked what size  W  
Covered Front Patio or Deck
Rear Wood Stairs Only.
Rear Wood Deck and Stairs.  If checked what Size  W   L
Rear Concrete Patio and Stairs. If checked what Size  W   L
Covered Rear Patio or Deck
Additional Wood Stairs Only.
Additional Wood Deck and Stairs.  If checked what Size  W   L
Additional Concrete Patio and Stairs. If checked what Size  W   L
Covered Additional Patio or Deck
TRIM OUT
Interior Trim    Drywall    Wallboard
Interior Flooring    Carpet  Wood  Tile  Vinyl  Combo
Exterior Trim    Hardi Board  Vinyl
ADDITIONAL NOTES
Notes on special conditions, requirements or specifications related to this job

   

 

 

 

 


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