AAT - New Customer Kit

Thank you for applying to do business with Advanced Auto Technology (AAT). Please give our team 24-48 hours after submission of the forms below to contact you about next steps.
How did you hear about AAT?*
Which best describes your business?*
What is the name of the AAT employee (first & last name), insurance carrier or website that introduced you to AAT?*

New Customer Information
Company Information
Company Name*
Tax ID*
Parent Company
Company Address*

Street Address

Street Address Line 2

CityState

ZIP Code
Phone*
Format: (000) 000-0000.
Fax
Format: (000) 000-0000.
Email (for main contact)*
Key Contact
Operational Contact*
Name
Phone*
Format: (000) 000-0000.
Email*
Same contact info
Billing Contact
Name
Phone
Format: (000) 000-0000.
Email
Alternate Contact (optional)
Name
Phone (optional)
Format: (000) 000-0000.
Email (optional)
Tax Information
What is your company’s sales tax status for Repair Orders?
TAXABLE on ALL Repair ordersTAX EXEMPT on ALL Repair OrdersTAX EXEMPT on SOME Orders
NOTE: that Resale Certificates can also be provided electronically. Refer to your specific state tax authority for a copy or more information.

Service Agreement
This Service Agreement ("Agreement") is entered into on EFFECTIVE DATE*, by and between Advanced Auto Technology ("AAT"), and CUSTOMER*, a STATE*, TYPE OF BUSINESS (LLC, PARTNERSHIP, C-CORP)*.
1. Services - AAT agrees to provide automotive solutions and related services to Customer, as outlined in the AAT Customer application. These services may include, but are not limited to, ADAS calibration, mobile mechanical and related services. Customer agrees to fully cooperate in AAT's delivery of services, provide accurate and complete information, including business details, primary contact name, and email address, for the effective delivery of services.

2. Data Sharing - Customer acknowledges that to request services through the AAT Customer application, data sharing is required. Customer can choose to share data either through CCC (Secure Share) or manually input the necessary information. The customer is responsible for ensuring the accuracy and completeness of the data provided.

3. Tax Exemption - If Customer is tax-exempt, Customer shall provide AAT with the necessary documentation to verify its tax-exempt status. AAT will not be responsible for any tax liabilities incurred by the Customer.

4. Payment Terms - Customer agrees to the following payment terms:
Collect on delivery: Payment is due immediately upon the completion of services.Net 30: Payment is due within 30 days from the date of the invoice.Credit card on file to be billed monthly (credit card authorization form on next page must be filled out).EFT/ACH: Accounts with Net 30 terms will be contacted by an AAT Representative with additional information.
5. Confidentiality - Both parties agree to keep all information exchanged during this agreement confidential. This includes, but is not limited to, business data, pricing, and proprietary information.

6. Termination - Either party may terminate this Agreement with 60 days written notice. If the other party breaches any material term orcondition of this Agreement and fails to cure such breach within 30 days of receiving written notice, the non-breaching party may terminate.

7. Governing Law - This Agreement shall be governed by and construed in accordance with the laws of the state of Texas.

8. Entire Agreement - This Agreement constitutes the entire agreement between the parties and supersedes all prior negotiations, understandings, or agreements, whether written or oral.

IN WITNESS WHEREOF, the parties hereto have caused this Service Agreement to be executed by their respective duly authorized representatives as of the day and year first above written.
Customer
Signature*

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Representative Name*
Job Title*
Date*

MonthDayYear

Credit Card Authorization
To authorize credit card automatic payments please fill in the following information:
I, FIRST NAME* LAST NAME*, authorize Advanced Auto Technology ("AAT") to charge my credit card ending in 4 DIGITS* . I authorize this credit card to be kept on file with AAT's banking institution. I authorize this card to be charged on or about the first business day of each month for any and all AAT invoices totaling up to $5,000. In the event total charges exceed $5,000 I will be contacted for approval. A receipt will be emailed to the email address provided below.
Company Name*
Name as it appears on card*
Full Name*
Email*
Signature*

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Date*

MonthDayYear
Please select "Next" below to continue filling out the form.

Arkansas Exemption Certificate

(GR-53 & AR Code 26-52-517(b)(1), (e), and (f) *NOTE: This form must be completed OR your certificate must be uploaded below if your business is tax exempt.
Yes - I will upload my completed certificate belowNo - I will complete the fillable form below
Upload your completed Arkansas Exemption Certificate:*

Cancelof
I hereby certify that I either hold or am the authorized representative of the holder of
Arkansas Sales/Use Tax Permit Number(PERMIT NUMBER), or that I am a nonresident purchaser or the authorized representative thereof and hold a similar permit issued by the State of (STATE) , Number (PERMIT NUMBER) , that this is a current and valid permit number; and that I am exempt from sales and use tax on the tangible personal property purchased from Protech Electronics LLC d/b/a Protech Automotive Solutions.
Merchandise Purchased is Exempt for the Following Reason:*
Purchaser's Business Activity*
Purchaser's Business Name (as Stated on Permit)*
Title/Position with Company*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Purchaser's Signature*

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Date*

MonthDayYear
Date
You can check out the details and general instructions below:
If you have questions or need help with these forms please contact us at: Acctsupport@ProtechAS.com
Should be Empty:

New Customer Information

Company Information

Key Contact

Tax Information

Service Agreement

Customer

Credit Card Authorization

W-9: Request for Taxpayer Identification Number and Certification

Part I - Taxpayer Identification Number (TIN)

Social Security Number

OR

Employer identification number

Part II - Certification

Arkansas Exemption Certificate