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BUNNserve
®
Managed Service - Account Request for Information
Thank you for your interest in establishing a BUNNserve
®
Managed Services account.
Because you have an existing BUNN
®
account, we only need a few more details to establish a service account. These details will help us determine if a service contract can be added to your existing account or if a stand-alone service account is required. The manner in which we setup your service account depends on your responses to the below questions about your business, purchasing and invoicing requirements.
Please fully complete the below information. To provide additional information pertaining to account contacts, location contacts, authorized approvers and equipment types, attach an Excel or CSV file. For your convenience, a downloadable Excel template is provided here:
Download Sample XLSX
Account Business Information
Business Name:
Business DBA:
Do you have a Dun & Bradstreet number?
Yes
No
Dun & Bradstreet #:
Business Phone:
Country:
Please select...
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos ( Keeling ) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Côte d ' Ivoire
Croatia ( Hrvatska )
Cuba
Cyprus
Czech Republic
Congo ( DRC )
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands ( Islas Malvinas )
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Prìncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands ( British )
Virgin Islands
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Address Line 1:
Address Line 2:
City:
State:
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Provinces:
Please select...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
State/Province:
Postal Code:
BUNN commercial equipment account number?
Account Level Bill To Information
Is the above listed business financially responsible for payment of invoices incurred by approved corporate locations, franchises or any other location(s) listed under this account.
Yes
No
Bill To Account Level Entity Information
Please provide the information for the financially responsible business entity.
Business Name:
Contact's Name:
Address Line 1:
Address Line 2:
City:
Country:
Please select...
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos ( Keeling ) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Côte d ' Ivoire
Croatia ( Hrvatska )
Cuba
Cyprus
Czech Republic
Congo ( DRC )
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands ( Islas Malvinas )
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Prìncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands ( British )
Virgin Islands
Wallis and Futuna
Yemen
Zambia
Zimbabwe
State:
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Provinces:
Please select...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
State/Province:
Postal Code:
Service Account Contact Information
Primary Contact
First Name:
Last Name:
Phone:
Email:
Accounts Payable Contact
First Name:
Last Name:
Phone:
Email:
Owner Contact
First Name:
Last Name:
Phone:
Email:
Sales Manager Contact
First Name:
Last Name:
Phone:
Email:
Additional Business Account Contacts
Business Role:
First Name:
Last Name:
Phone:
Email:
Add another contact
Business Role:
First Name:
Last Name:
Phone:
Email:
Add another contact
Business Role:
First Name:
Last Name:
Phone:
Email:
Associated Locations, Location Contacts & Equipment Information
Provide the following list of information:
Associated locations:
Location business name
Location corporate store number
Location contact name
Location phone number
Location address
Location operating hours
Equipment Type:
Model name
Model number
Serial number
Details
Provide additional information pertaining to account contacts, location contacts, authorized approvers and equipment types here:
Select the category of equipment to be serviced:
Coffee
Tea
Espresso
Powdered
Juice
Ultra®
Nitron®
Cold Brew
Hot Water
Bean to Cup
BUNN refresh®
Other
Additional Equipment Information:
Service Account Purchasing & Invoicing Requirements
How do you want to receive service invoices?
Email
Postal Service
Email invoices to:
Primary Contact
Owner
Sales Manager
Accounts Payable Contact
Other
Note: Make sure the contact information is populated above for the contact you selected.
Other Email
Mail invoices to:
Mail to same account address above.
Other
Bill To Mailing Address
Business Name:
Contact's Name:
Address Line 1:
Address Line 2:
City:
Country:
Please select...
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos ( Keeling ) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Côte d ' Ivoire
Croatia ( Hrvatska )
Cuba
Cyprus
Czech Republic
Congo ( DRC )
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands ( Islas Malvinas )
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Prìncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands ( British )
Virgin Islands
Wallis and Futuna
Yemen
Zambia
Zimbabwe
State:
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Provinces:
Please select...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
State/Province:
Postal Code:
Purchase Order required for payment of service invoice?
Yes
No
Email your POs to:
eorders@bunn.com
Special Purchase Order Instructions:
Business is Tax Exempt for service purchases?
Yes
No
BUNN W-9 taxpayer ID form required?
Yes
No
Email BUNN’s W-9 to:
Vendor on-boarding compliance forms required for payment of service purchases?
Yes
No
Online Portal Invoice and Payment Requirements
** Additional administrative fees may apply **
Online portal invoice entry required for payment of service invoices?
Yes
No
Email your requirements to
adrienne.sweet@bunn.com
Portal Contact
First Name :
Last Name:
Phone:
Email:
Portal Website Address:
Portal Invoice Requirements:
Service Information
Select the applicable service option(s) below:
Equipment Installation Services
Equipment Removal Services
Equipment Preventative Maintenance Services
Equipment Reactive Services
Installation
Estimated number of installations per month:
Rate plan for installations:
Flat Rates
Time and Material Rates
Removals
Estimated number of removals per month:
Rate plan for removals:
Flat Rates
Time and Material Rates
Preventive Maintenance
Estimated number of PMs per month:
Rate plan for PMs:
Flat Rates
Time and Material Rates
Reactive Services
Estimated number of Reactive Services per month:
Note: Reactive service plans can only be billed at time and material rate.
The BUNNserve
®
basic plan provides Standard Repair Contract Limits set for labor, travel, and parts. The plan also provides a “Not To Exceed” (NTE) Limits for all non-warranted repairs. Repairs exceeding the limit and overtime fees require customer pre-approval.
Authorized to approve dispatch of a field service technician.
Authorized to approve field service technician overtime rates for labor and travel outside of normal business hours.
Authorized to approve repairs exceeding the “Not To Exceed” standard repair limit.
Service Request Authorization
Who is authorized to request service on equipment?
Anyone calling from approved locations
Only specific contacts at the location
Other
Did you include these authorized contacts in your list attached for locations and equipment?
Yes
No
Do you want to enter these manually?
Yes
No
Service Request Authorizer
Name:
Cell Phone:
Office Phone:
Email:
Add another service request authorizer
Service Request Authorizer 2
Name:
Cell Phone:
Office Phone:
Email:
Add another service request authorizer
Service Request Authorizer 3
Name:
Cell Phone:
Office Phone:
Email:
Explain authorization process:
Approval for Overtime & "Not To Exceed" (NTE) Service Fees
Who is authorized to approve overtime fees and fees over the “Not To Exceed” (NTE) limit?
Anyone calling from approved locations
Only specific contacts at the location
Other
Did you include these authorized contacts in your list attached for locations and equipment?
Yes
No
Are they the same contacts added above to authorize service?
Yes
No
Do you want to enter these manually?
Yes
No
Overtime & NTE Fee Approver
Name:
Cell Phone:
Office Phone:
Email:
Add another overtime & NTE fee approver
Overtime & NTE Fee Approver
Name:
Cell Phone:
Office Phone:
Email:
Add another overtime & NTE fee approver
Overtime & NTE Fee Approver
Name:
Cell Phone:
Office Phone:
Email:
Explain overtime and NTE approval process:
Please don’t hesitate to call or email us if you have questions; we are here to help facilitate your business.
BUNNserve® Onboarding Specialist
Phone: 800-637-8606
Email:
bunnserve.application@bunn.com
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