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Request More Information on Our Billing Management Service

We are proud of our certification as a WBE (Women's Business Enterprise).

In order to receive accurate information, please submit this form as completely as possible. The more detail you include, the more thorough and accurate our quote can be. For your convenience, we can also be reached at 800-282-9035.

Contact Information *Your Name:

*Your E-mail Address:

*Phone:

Fax:

Are You the Final Decision-Maker?
Yes
No

About Your Company *Company Name:

Address:

City, State, Zip:

*Type of Business:

Number of Employees:

Number of Branches or Offices Worldwide:

Locations of These Offices:

About Your Needs *What Level of Service Do You Need?
Complete Cost Management
Consolidated Ordering Only
Consolidated Billing Only
Not Sure

*Estimated Annual Dollar Volume:

*Number of Orders/Invoices Placed Monthly:

*Do You Currently Use a Consolidated Billing Company?
No
Yes

*Will You Require Paperless Transactions?
No
Yes

*Are You EDI Capable?
No
Yes

*What Business Management Software Are You Currently Running?

When Will You Be Making This Decision?

Details or Comments:

How Did You Hear About Us?
Business Referral
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Medical & Hospital Supplies	Industrial & Commercial Supplies	Ordering & Billing Management	Business Furniture & Fixtures
Industrial Gases & Welding Equip.	Security Scanners & Detectors	Promotional & Printing	Electrical Supplies & Cables
Janitorial Supplies & Equipment	Uniforms & Work Clothes	Computer Hardware & Software	Safety & First Aid Supplies
Custom Stainless Steel	Plumbing/HVAC	Industrial & Medical Chemicals	Trucks, Vehicles, Parts & Supplies

Sales & Distribution Center 2733 N. Pulaski Chicago, IL 60639		Administrative Offices 6133 N. Northwest Highway Chicago, IL 60631
Phone: 800-282-9035 or 773-763-9566 Fax: 773-763-9587 Email: info@progressiveindustriesinc.com

Request More Information on Our Billing Management Service

Progressive Industries, Inc.