Durrie Sales Customer Agreement

Durrie Sales Reseller Agreement
Application Status
We’re excited to work with you! Durrie Sales supplies products exclusively to authorized distributors and OEMs. To get started, we just need a few details.
You must confirm the following to proceed:*

I confirm that all products ordered are for resale only.I am authorized to open an account on behalf of my company.I understand the FIRST ORDER must be at least $50.00 NET, and payment must be made in advance via credit card or ACH, unless otherwise approved by your salesperson.
Applicant's Contact Information
Your Name:*

First NameLast Name
Your Email:*
example@example.com
Your Phone Number:
Enter a valid phone number.Format: (000) 000-0000.
If you have been working with a salesperson, select below:*

Tax Exemption Information
Durrie Sales is only authorized to sell to other resellers. Per the state of Illinois, we must obtain a copy of your State's Tax Exemption Certificate. If you need help finding your State's Tax Exemption Certificate, click on the link below and choose your state.

Durrie Tax Exemption Certificates
State Issuing Tax Exemption Certificate:*

Street Address

Street Address Line 2

CityState

Zip Code
State Resale Number:*
Upload Tax Exemption Certificate:

Cancelof

Contact Information
Accounts Payable
Accounts Payable Person:*

First NameLast Name
Accounts Payable Phone Number:*
Enter a valid phone number.Format: (000) 000-0000.
Email to Send Invoices:*
example@example.com
Order Confirmation
Provide the email address you want order confirmations to be sent to if different than the contact name and email on your Purchase Orders.
Email for order confirmations:
example@example.com

Request for Terms (Optional)
Would you like to apply for Terms?

YesNo
Do you have a PDF of the Trade References you would like to upload o enter them manually?

UploadManually
Trade References

Cancelof
Reference 1
Business Name
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Enter a valid phone number.Format: (000) 000-0000.
Reference 2
Business Name
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Enter a valid phone number.Format: (000) 000-0000.
Reference 3
Business Name
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Enter a valid phone number.Format: (000) 000-0000.
Reference 4
Business Name
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Enter a valid phone number.Format: (000) 000-0000.
Reference 5
Business Name
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

Durrie Sales Reseller Agreement