Appliance Supply Intake Form

Please provide detailed information about your project to help us serve you better.

Contact Information

Email Address *

Project Name *

Developer / General Contractor Company *

Primary Contact (Name & Title) *

Phone *

Project Address *

Project Timeline

Estimated Project Start Date

Estimated Completion Date

Project Details

New development or existing property? *

Do you need haul-away service? (Existing property only)

Total number of residential living units *

Number of ADA units *

Sustainability or efficiency requirements (e.g., ENERGY STAR)? *

Multi-structure development? If yes, how many buildings? *

Multi-level structures? If yes, how many floors? *

Elevators in structures with more than 1 floor? *

Appliance Requirements

What appliances are needed for the residential units? *

Refrigerator Range/Oven Dishwasher Microwave Washer Dryer Other

What appliances are needed in the common area? *

Refrigerator Range/Oven Dishwasher Microwave Other

What appliances are needed in the office or admin area? *

Refrigerator Microwave Coffee Maker Other

Delivery & Installation

Installation needs? *

Delivery Only Installation / Hook-up Required

Projected initial appliance delivery or acceptance date? *

Expected delivery phasing? *

Loading dock available? *

Freight elevator or padded elevator available? *

18-wheeler truck access restrictions on the property? *

Additional Information

Accept upgraded or substitute appliances if backordered? *

Additional notes or requests *

Johnson Development Group

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