DMX MUSIC SUBCONTRACTOR SURVEY

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Contact Details
Company Name

Shipping Address Billing Address Same as shipping
Address Line 1 
Address Line 1 
Address Line 2 
Address Line 2 
City 
City 
State / Province
State / Province 
Zip Code Zip Code
Country Country

Hours Of Operation Open Close
Weekdays
Saturday

Briefly describe how your company handles after hour and weekend service calls.

Primary Phone # After hours number is a
Fax # Cell Phone   Pager   Answering Service   Home
Emergency / After Hours # Other   

  Name Phone # Cell Phone Email Address
Owner
Installations
Service
Billing
Primary Technician
Secondary Technician

Territory
Countries or regions covered free of travel fees. DMX MUSIC does NOT pay mileage, trip charges, surcharges, or service fees.

Service Rates / Details
Note: Current subcontractors install and service rates are on file and not subject to change without prior approval. New subcontractor applicants will be contacted if rates exceed current market standards.
Standard Hourly Rate /hour
Union Installs /hour
Service /hour
Emergency Service /hour
Travel outside standard service area /hour   **
   **Rate for travel time only. Do not include service or install rates. Travel time is based on 1 technician per hour unless otherwise approved.

Guaranteed Response Time
DMX MUSIC guarantees to its customers that a technician will be on site within 48 hours or two business days. Can you commit to
meeting a 48 hour response time?
Yes   No
Comments:

Licensing and Permits
Is your company a licensed low voltage contractor?
Yes   No

In which state(s), county(ies), and/or municipality(ies) is (are) your company licensed to contract for low voltage installations?
Please include all relevant license numbers.

Does your company have the ability to pull permits in each of the locales listed above?
Yes   No    Does not apply
If not, please explain:

Union Affiliates
Is your company Union Affiliated?
Yes   No        If yes, what union and local?

If not, does your company have access to a union subcontractor?
Yes   No

Music and A/V Integrator Relationships
List the following companies that you currently perform work for. (check all that apply)
Muzak    Bose    Music Choice    XM Radio    Playnetwork
Crow's Nest (CNE)    Sirius/AMTC    Other

Qualifications for Government Contracts
Does your company qualify as a small, disadvantaged business? Yes   No
... a women owned small business? Yes   No
… a veteran owned small business? Yes   No
… a minority owned small business? Yes   No
… a HUBZone small business? Yes   No
… a service-disabled, veteran owned small business? Yes   No
Does your company possess a government issued security clearance? Yes   No

Technicians
  Installations / Service
Full Time
Part Time

Does your company use subcontractors?
Yes   No

Core Competencies
How frequently do you install or service these types of systems
 
Never
Rarely
Occasionally
Frequently
Audio Distributed Sound (70 V)
  Live Sound
  Residential
 
Never
Rarely
Occasionally
Frequently
Video RF Distribution and balancing
  Composite / RGB
 
Never
Rarely
Occasionally
Frequently
Satellite Direct Broadcast
  DSS
 
Never
Rarely
Occasionally
Frequently
Computer Control AMX
  Creston
  Audio DSP
 
Never
Rarely
Occasionally
Frequently
Misc. Phone Systems
  Drive Through
  Surveillance/CCTV
  Data Networks
  Hanging Televisions
  Equipment Racks
  Loudspeakers in excess of 50 pounds

Professional Associations
Syn-Aud-Con      NSCA     ICIA    
List all other associations.

Tools
True RMS Multi meter or Volt and Ohm Meters Yes   No Punch Tool w/ 66 and 110 blades Yes   No
Tone Generator for line and microphone levels Yes   No Staple Gun for wire staples Yes   No
Inductance Wand and Toner Yes   No Coax crimp tool for F fittings Yes   No
Impedance Meter Yes   No        …. BNC fittings Yes   No
Real Time Analyzer Yes   No        …. RCA fittings Yes   No
Sound Pressure Level (SPL) Meter Yes   No Amp Meter Yes   No
Butt Set or Headphone amplifier Yes   No Video Test Generator Yes   No
Thermal Labeler Yes   No Oscilloscope Yes   No
Soldering Iron Yes   No Wall Sensor / Stud Sensor Yes   No
Heat Gun Yes   No Torque Wrench Yes   No
Scaffold Yes   No Material Lift (Genie or similar) Yes   No
Hammer Drill Yes   No Laptop Computer Yes   No
Push Rods Yes   No Phase and Polarity Checker and Generator Yes   No
  Drywall saw, keyhole saw, Roto Zip, or similar cutting device Yes   No

Liability Insurance
I have submitted or currently have on file a certificate of liability insurance showing DMX MUSIC as an additional insured. (1,000,000 General Aggregate)
Yes   No        In Process

TAX ID #

I acknowledge that this form was completed accurately and I understand all information submitted is subject to review and verification by DMX MUSIC.