Answer After-Hours Enrollment Form
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1 Company Information Company Name Phone Fax Contact - First Name Contact - Last Name Address Street Address City State Zip Code Mailing Address City State Zip Code Approximate Number of Customers Serviced by This Location Additional addresses to send your reports Your daily activity reports will be ed when your office opens. Hours of Operation Monday - Friday Saturday Time Zone Select Call Package To adjust for seasonal changes of call volume, you may specify which call package option you would like to participate in during specific periods of the year. Please select a call package option for your busy and slower seasons as applicable using the tables below. Excess calls will be billed at $.99 each. From Month: To: Month From Month: To Month: Select Monthly Calls Monthly Rate Select Monthly Calls Monthly Rate 60 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $269.99
2 MASTER ON-CALL LIST This list covers: Delivery & Service Calls Delivery Calls Only Service Calls Only IMPORTANT NOTICE: Should you wish to specify a separate on-call list for DELIVERY personnel (for out-ofproduct calls) and SERVICE personnel (for product leaks, appliance emergencies or other service calls), please complete an additional sheet as needed. Please list your on-call personnel below. List any person that could be on-call for your company. This list will be used to create an on-call schedule in our database. You will be contacted and provided instructions on how to manage your on-call schedule using our online system. What day does your on-call schedule change? Dedicated On-Call Pager/Cell Phone (If Applicable) On-Call Pager Number On-Call Cell Phone Number Name of On-Call Rep Pager (If Applicable) Cell Phone Number Home Phone Number Backup On-Call Personnel After waiting the appropriate amount of time for a response from the designated on-call representative (based on call type), the operator will attempt to contact your designated backup personnel. It is recommended that you list TWO OR MORE representatives (managers, etc.) to serve as backup contacts to your designated on-call personnel. Priority Name of Backup Personnel Cell Phone Number Home Phone Number #2 #3 #4 #5
3 PERS Answer After-Hours/Call Protocol Worksheet It is our objective to provide your company with professional answering services that meet your company s specific needs. In order to do so, we must understand the manner in which you expect your after-hours calls to be addressed. All call packages are based upon your company managing your on-call schedule and protocol using our online internet based system, which provides incredible benefits and flexibility. Our online system allows you to generate reports, view call activity and update your on-call list at any time. Should your company or operating office not have internet access and/or you are otherwise unable to update your on-call schedule online, a $25.00 account management fee will be added to your selected call package price each month. 1. Our operators will attempt to contact your designated on-call personnel for ALL calls reported as product leaks or suspected leaks. 2. Non-urgent customer calls (such as billing/account questions, requests to schedule deliveries, and nonurgent matters) will simply be entered into the call log for inclusion in your daily activity report. For these types of calls, on-call personnel will not be contacted. 3. Should you choose to forward your phones to our service during normal business hours, it is your responsibility to notify our office when the phones are being forwarded and when you return them back to your office. This provides our operators the ability to address customer questions about your availability. 4. When the answering service has paged your designated on-call representative or is unable to make contact via telephone and has left a voice message, the operator will move to the next contact number listed within the following time frames: a. 10 minutes for calls reported as product leaks or suspected leaks b. 20 minutes for out-of-product or appliance emergencies for commercial customers (as applicable) c. 30 minutes for out-of-product or appliance emergencies for residential customers (as applicable) 5. Our operators will call the contact numbers on your call list in the order you have given. 6. After waiting the appropriate amount of time for a response from the designated on-call representative (based on call type), the operator will attempt to contact your designated backup personnel: a. When contact is made, the backup person will be informed that there was no response from the designated on-call representative and the call information will be provided. b. If contact is not made with the backup person, a message will be left and the operator will continue to move through the back up call list until contact is either made or there is no one left to call. After this point, no further attempts will be made to contact your company. Please review the above policies and procedures with your on-call personnel to ensure they fully understand our call protocol. I accept the terms of the above call protocol.
4 Company Call Protocol Our operators will follow your company s call protocol specified during this application process. Please identify your after-hours policy and when you would like our operators to contact your on-call personnel. Out of Product Calls 1. For what type of callers should your on-call personnel be contacted for Out of Product calls? Routed Customers Will-Call Customers Commercial Accounts 2. What does your company consider a Routed Out of Product call for which you want your on-call personnel contacted? 0% Only 5% or less 10% or less 15% or less 20% or less 3. What does your company consider a Will-Call Out of Product call for which you want your on-call personnel contacted? 0% Only 5% or less 10% or less 15% or less 20% or less We do not make after-hours deliveries to Will-Call Customers If Will-Call customers are required to pay a fee for after-hours deliveries and you would like us to reference this fee please indicate the amount of the fee $. 4. What does your company consider a Commercial Out of Product call for which you want your on-call personnel contacted (excluding cylinders)? 0% Only 5% or less 10% or less 15% or less 20% or less Always contact on-call personnel regarding our commercial accounts 5. You may specify the hours during which on-call personnel should NOT be contacted for Residential Out of Product calls: DO NOT contact on-call personnel for ROUTED Out of Product calls from AM PM to AM PM DO NOT contact on-call personnel for Will-Call Out of Product calls from AM PM to AM PM
5 6. You may specify the hours during which on-call personnel should NOT be contacted for Commercial Out of Product calls: DO NOT contact on-call personnel for Commercial Out of Product calls from AM PM to AM PM Appliance Calls (Excluding reports of leaks/odor we always call for leaks/odors) 7. For which type of callers should your on-call personnel be contacted for an appliance related emergency? Routed Customers Will-Call Customers Commercial Accounts 8. What does your company consider a Routed Appliance Emergency for which you want your on-call personnel contacted (check all that apply): Any appliance problem (pilot light, furnace, water heater, stove) Other 9. What does your company consider a Will-Call Appliance Emergency for which you want your on-call personnel contacted (check all that apply): Any appliance problem (pilot light, furnace, water heater, stove) Other If Will-Call customers are required to pay a fee for after-hours Appliance Emergency calls and you would like us to reference this fee please indicate the amount of the fee $. 10. What does your company consider a Commercial Appliance Emergency for which you want your oncall personnel contacted (check all that apply): Any appliance problem (pilot light, furnace, water heater, stove) Other 11. You may specify the hours during which on-call personnel should NOT be contacted for Residential Appliance Emergency calls: DO NOT contact on-call personnel for ROUTED Appliance Emergency calls from DO NOT contact on-call personnel for Will-Call Appliance Emergency calls from AM PM to AM PM 12. You may specify the hours during which on-call personnel should NOT be contacted for Commercial Appliance Emergency calls: DO NOT contact on-call personnel for Commercial Appliance Emergency calls from Tank or Regulator Issues (Excluding reports of leaks/odor we always call for leaks/odors) 13. For which type of callers should your on-call personnel be contacted for Tank or Regulator related emergencies? Routed Customers Will-Call Customers Commercial Accounts
6 14. You may specify the hours during which on-call personnel should NOT be contacted for Residential Tank or Regulator related emergencies: DO NOT contact on-call personnel for ROUTED Tank or Regulator related emergencies from DO NOT contact on-call personnel for Will-Call Tank or Regulator related emergencies from If Will-Call customers are required to pay a fee for after-tank or regulator related emergencies and you would like us to reference this fee please indicate the amount of the fee $. 15. You may specify the hours during which on-call personnel should NOT be contacted for Commercial Tank or Regulator related emergencies: DO NOT contact on-call personnel for Commercial Tank or Regulator related emergencies from Miscellaneous 16. You may indicate that callers should be asked to provide their account number if they have it readily available. Please check your preference: Request account number Do not ask for account number/not applicable 17. Would you like your on-call representatives contacted about non-customer calls after-hours? Please contact on-call representatives for non-customers after-hours Do not contact representatives for non-customers after-hours Finance Policy PERS extends credit as a courtesy to our customers. Our payment terms are due upon receipt. After 30 days, an invoice is considered outstanding. Finance charges equal to 10% of the balance due will be added to any invoice 45 days outstanding. Accounts Payable Contact First Name Accounts Payable Contact Last Name Telephone Number Accounts Payable Address Address (s) to Send Monthly Invoice I have verified the above information is correct. Signature Date
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