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Fremont Construction & Contracting Co.
FREMONT CONSTRUCTION & CONTRACTING CO.
Ph: (419) 370-7774  |  fremontconstructioncontracting@gmail.com
www.fremont-construction.com  |  Fremont, OH 43420
FORM NO. FCC-INT-01 Client Intake Form Revised May 2019   Page 1 of 3
Section 1 — Client Information All Fields Required
1A. First Name *
1B. Last Name *
1C. Date of Inquiry *
1D. Company / Business Name (if applicable)
1E. Relationship to Property *
1F. Primary Phone *
1G. Alternate Phone
1H. Email Address *
1I. Mailing Address — Street *
1J. City *
1K. ST *
1L. ZIP *
1M. How Did You Hear About Us? *
1N. Referred By (name, if applicable)
1O. Preferred Contact Method: *
1P. Best Time to Reach You: *
Section 2 — Property Information
2A. Project Address (if different from above)
2B. City
2C. ST
2D. ZIP
2I. Structure Type: *
2J. Ownership Status: *
Section 3 — Project Details
3A. Type of Service Requested (check all that apply): *
3B. Briefly Describe the Scope of Work: *
3E. Is This Project Insurance / Claim Related? *
3F. Material / Product Preference (brand, color, style — if known)
3G. Specific Requirements or Restrictions?
3H. What Prompted You to Start Looking Into This Project? (e.g. Storm Damage, Cosmetic Upgrade, Need Additional Space) *
Fremont Construction & Contracting Co. — Client Intake Form CONFIDENTIAL — FOR INTERNAL USE ONLY Page 1
Fremont Construction & Contracting Co.
FREMONT CONSTRUCTION & CONTRACTING CO.
Ph: (419) 370-7774  |  fremontconstructioncontracting@gmail.com
www.fremont-construction.com  |  Fremont, OH 43420
FORM NO. FCC-INT-01 Client Intake Form Revised May 2019   Page 2 of 3
Section 4 — Budget & Timeline
4A. Have You Established a Budget for This Project? *
Approximate Amount $ *
4B. Payment / Financing Method (anticipated): *
4C. Would Financing Be of Interest? *
4D. Desired Start Date / Timeframe: *
Section 5 — Decision Making & Qualification
5A. Who Is the Primary Decision-Maker for This Project? *
5B. How Soon Do You Plan to Make a Hiring Decision? *
5C. Have You Hired Fremont Construction Previously? *
5D. Any Specific Concerns, Questions, or Notes for the Estimator?
5E. Please Rank the Following Factors in Order of Importance When Selecting a Contractor (1 = Most Important, 5 = Less Important) *
Price / Cost
Quality of Craftsmanship
Project Completion Speed / Timeliness
Communication & Responsiveness
Warranty / Long-Term Support
Fremont Construction & Contracting Co. — Client Intake Form CONFIDENTIAL — FOR INTERNAL USE ONLY Page 2
Fremont Construction & Contracting Co.
FREMONT CONSTRUCTION & CONTRACTING CO.
Ph: (419) 370-7774  |  fremontconstructioncontracting@gmail.com
www.fremont-construction.com  |  Fremont, OH 43420
FORM NO. FCC-INT-01 Client Intake Form Revised May 2019   Page 3 of 3
Office Use Only
Section 7 — OFFICE USE ONLY Sales / Estimator Completion Required
7A. Intake Date
7B. Intake Taken By
7C. Lead Source
7D. Sales / Intake Notes:
7E. Estimator Notes / On-Site Observations:
7F. Outcome / Disposition Notes:
Intake Rep
Estimator
Date Reviewed
Fremont Construction & Contracting Co. — Client Intake Form CONFIDENTIAL — FOR INTERNAL USE ONLY Page 3