General Information
Business Name
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Remit to
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Same
Different
Remit to
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Main line
-
Area Code
Phone Number
Website
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Inside Contact Information
Primary CSR
When primary CSR is unavailable, is a back up assigned?
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Yes
No
Backup CSR
Quotations Primary / Manager
Regional Manager
Additional Contacts?
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Yes
No
Additional Contact
Additional Contact
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Sales Information
Agent Sample Policy
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Yes
N/A
* Sample for Agent to inventory, not for installation use
Customer Sample Policy
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Yes
N/A
* Sample for installation, subject to return policy
Agent / Manufacturer Accommodation Policy
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Yes
N/A
* Product provided by agency or manufacturer for installation and use in customers business - marketing
Do you provide color chips?
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Yes
No
How do we order?
* Please include full information *
Spec Registration
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Online
Email
Website
Email
example@example.com
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Ordering Information
Email to send HFR and PO's
example@example.com
Post Sale email / Process
example@example.com
Order Requirements
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Yes
No
* Deposit requirements, approval drawing requirements etc.
Order Minimums
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Yes
No
Freight Terms
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Prepay and Add
Always Charge
Freight Allowance
Other
Terms and Conditions
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Website link
PDF
PDF
Browse Files
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of
Additional documents for agent use?
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