New Account setup

Company*

ABN*

Address to be Serviced

Number

Street

City

State

Post Code

Business Phone Number

Business Email*

Business Director/Owners Name and Address*

Managers Name

First*

Last*

Managers Mobile (in case o emergencies)*

Managers Email*

Account Manager

First Name*

Last Name*

Account Managers Phone

Account Managers Email

Accounts Address (if different to Business)

Number

Street

City

State

Post Code

Company Name (if different to Business)

Enviroclean Oz normally email accounts to you. How would like to receive yours?*

Payment Terms

Enviroclean Oz sends out invoices on the 20th day of each month and you will be billed to the end of that invoiced month. Payment is required anytime before the 7th day of the following month. Late payment reminders get sent out by email on the 8th day and service suspends on the last day of that month for any unpaid invoices unless prior arrangements have been made with Enviroclean Accounts department. An Enviroclean Timeline for accounts is displayed below. Do you agree to accept the accounts terms and proceed with your service.

Alternate payment method
You can also choose like most of our clients to have your payment made weekly through Paysmart and this will have an $11.00 once off setup and weekly fee of $1.30 per deduction however, you will save 5% off your cleaning. Please tick the option below to have us send you your Paysmart payment link.
I agree

Point of Contact and Security

First*

Last

Email*

Landline Phone

Mobile*

Security Company Phone (if applicable)

Security Code for Cleaner and Instructions to enter*

Security Company Voice Code (if applicable)

Name and Phone of current trade reference**

Date you would like to commence your service*

I would like my clean done between these hours.*

What day would you like your business cleaned?

What FREE inclusion option would you like?*

The bins are $75.00 each and charged on your first invoice. You own them and we service up to (3) bins free moving forward (Additional bins $5.00 per service. How many bins do you require?

List any special requirements relating to your site here

Do you accept all terms of your service proposal?*