Agent Application Form

A. Company Profile & Contact Information

Company Name

Country of Registration

Business Registration Number (if applicable)

Business regions (County and States)

Contact Person – Full Name & Title

Phone Number (incl. WhatsApp)

Email

Business Website (if available)

Years in Operation

Number of Employees

Languages Spoken by Key Staff

B. Business Overview

Type of Business Currently Provided (e.g., Portable Restrooms Rental Services)

Estimated Annual Revenue (USD, Approximate)
Less than $200,000$200,000-$500,000$500,000-$10,000,000Over $10,000,000

Storage Capacity (Size / Location)

Number of Portable Restrooms Currently Owned
1-5051-100More than 100

Experience Importing Equipment from Abroad:
NoYes

Registered on Public Procurement Platforms:
NoYes, please list:

Growth or Expansion Plan:
NoYes, please describe:

Have you provided services for the following?
Dubai Expo.Neom/Qiddiya (Saudi Arabia).Hajj.Not yet.Other:

Regulatory Bodies Overseeing Sanitation:
Municipality / Urban Planning Department.Ministry of Environment.Civil Defense or Fire Safety Authority.Other:

Valid Sanitation/Waste Disposal License:
No.Yes. Specify country:

Client Segments Served:
VIP clients.Royal family members.Government projects.None.

Does Regional Climate Affect Operations?
Not significantly.Yes. Please describe your current solution:

Can You Handle On-Ground Storage & Logistics?
No.Yes.

C. Service & Market Reach

Services Provided
Portable Restroom RentalsEvent logisticsConstruction SupportOther:

Areas You Currently Serve Distribution Capabilities\(e.g., coverage radius, response time)

Working with Other Brands?
NoYes, please list:

Government or Large-Scale Project Experience:
NoYes

D. Cooperation Intention

Preferred Form of Cooperation
Exclusive AgentNon-exclusive DistributorProject-basedOther

Local Maintenance / Cleaning Services
NoYesThrough partner.

Support Capabilities:
On-site setupRemote support onlyBothNot available.

Peak Seasonal Demand Observed? If yes, please specify:

E. Waste Disposal License & Regulatory Compliance

Specific Licenses Required?
No.Yes. Please describe:

Issuing Authority

License Validity
From To

Scope of Authorization

F. Rental Interest for Planning

How many Portable Restrooms are you interested in renting?

Estimated Rental Duration (months/years):

G. Other Comments or Questions

Would you like your logo to appear on the product?
NoYes

Customization Requests / Special Comments

H. Declaration

I confirm that all information provided is accurate and true to the best of my knowledge.
I understand this application does not constitute a binding agreement
I agree to comply with GIGONE LLC’s agency policies and acknowledge that any disputes shall be governed by the laws of the State of Georgia, USA.
I have read and agree to the GIGONE LLC Compliance Statement
I understand all submitted information will be handled according to applicable data protection laws

Signature

Name (Print):

Date: