Cost Containment $trategies, Inc.
100 North Federal Highway, Suite 1123, Fort Lauderdale FL 33301 (954) 479-1900
40 East 20th Street, Suite 204, New York, NY 10003 (646) 404-6060
Client Questionnaire
Please fill out the following questionnaire to the best of your ability. The information contained herein will only be used by CCS to determine the areas we can most efficiently serve you
Once completed, please fax the form in its entirety to 877-227-1784. Thank you!
General Information
Please describe your type of business: ______
______
# of locations: ______# of employees - full time: ______/ part time: ______
In what states do you have physical locations? ______
______
______
Are these locations (circle one) owned / rented / combination of both?
Telecommunications
Telephone Service Provider(s): ______
Are you under contract? Y or N If yes, expiration date? ______
I nternet Service Provider(s): ______
Are you under contract? Y or N If yes, expiration date? ______
Do you have T-1 or DSL service?
Cell phone provider(s)? ______# of units? ______
Cost Containment $trategies, Inc.
Payment Processing - Credit -Debit & Gift Cards
Do you currently take credit and debit cards as a form of payment? Y or N
Who is your current vendor? ______
Are you under contract? Y or N If yes, expiration date? ______
Do you require your customer’s card be present to conduct a transaction? Y or N
What software are you currently using? ______
What equipment are you currently using? ______
Is the equipment Owned or Leased?
Do you accept checks as a form of payment? Y or N
Who is your current vendor? ______
Do you have a Gift Card program? Y or N
Who is your current vendor? ______
Utilities
Do you pay your own utilities? Yes / No
Do you use an Energy Savings Company (ESCO)? Y or N If so, who? ______
Who is your current Gas Provider(s)? ______
Who is your current Electric Provider(s)? ______
Cost Containment $trategies, Inc.
Group Benefits
Do you provide 401K plans for your employees? Y or N
If so, who administers the plan? ______Monthly Admin Fee ______
Who is your current payroll company? ______
Who is your current Health Insurance Provider? ______
Do you use a 3rd party to fight unemployment claims? Y or N
If so who?______
Do you have EPLI Insurance? Y__ or N___ Monthly Cost______
Do you have E&O Insurance? Y__ or N___ Monthly Cost______
Do you have a full time H/R Staff? Y__ or N___ If so how many people on staff?______
Printing
Do you hand out you company brochures? Y or N If so, how many colors?______
Do you create in store promotional posters or banners? Y or N If so, how often? ______
Business cards? Y or N Colors? ______
Other? ______
Cost Containment $trategies, Inc.
Freight & Shipping
Who is your current Shipping Co(s)? ex. Fed Ex, DHL,UPS______
How much do you spend monthly? ______
Are you under contract? Y or N If yes, expiration date? ______
Are you currently using auditors? Y or N Who? ______
Equipment Leasing & Finance
Do you currently lease/finance any equipment? Y or N
What type of equipment? ______
Who is(are) your current funding source(s)? ______
Once again, we at CCS would like to thank you for taking the time to complete this questionnaire.
If you have any questions please call us toll free at 877- 227-1787
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