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2017 SEAWIDE DISTRIBUTION CATALOG

41698 Eastman Drive, Murrieta, CA 92562 Phone: (949) 515-5360 Fax: (951) 600-8530 www.seawide.com I/WE herewith make application to SEAWIDE MARINE DISTRIBUTION (hereinafter “Vendor”) for credit, or an increase or reconfirmation of our existing account. The undersigned gives and grants Vendor permission to verify or re-verify all information stated herein at any time. I/WE hereby agree that all credit granted and/or extended shall be paid timely in accordance with the Vendor’s set terms. PLEASE ANSWER ALL QUESTIONS Company Name __________________________________________________ Corporation LLC Partnership Sole Ownership DBA Name __________________________________________________ Federal Tax ID_____________ Business Type __________________ Bill to Address __________________________________________________ City ______________________ State _____ Zip __________-______ Phone ( )______________________ Fax ( )________________ Co Email ________________________________ Use for news/specials Ship to Address _________________________________ City _____________________ State _____ Zip ________-______ Freight Forwarder Freight Forwarder Name ________________________ Years in Business # ______ Amt of Credit Desired $____________ COD Credit Card What markets does your business target? Marine Outdoor Internet Automotive Other ___________________________________ Do you have a Retail Storefront/Dealership/Boatyard? __________ Web Address _______________________________ % sales from site? ______ FINANCIAL INFORMATION Bank _______________________________ Acct# ________________________ City________________ State _____ Phone ( ) _____________ Contact ____________________ Bank Credit Line ________________ Secured Yes No Type of Security ____________________________ Has applicant or any owners, principles, members, officers, or directors ever filed a voluntary petition for bankruptcy, been adjudged bankrupt, or made an assignment for the benefit of creditors? Yes No If yes, please explain_________________________________________________ TRADE REFERENCES (Required) Name ________________________________ State ____ Phone ( ) _______________ Fax ( ) __________________ Acct # _____________ Name ________________________________ State ____ Phone ( ) _______________ Fax ( ) __________________ Acct # _____________ Name ________________________________ State ____ Phone ( ) _______________ Fax ( ) __________________ Acct # _____________ Name ________________________________ State ____ Phone ( ) _______________ Fax ( ) __________________ Acct # _____________ PLEASE PROVIDE CONTACTS WITH THEIR TITLES AND CONTACT INFO Co Principal ______________________________ Title _______________ Phone ( ) ______________ Email _____________________________ Sales Contact _____________________________ Title _______________ Phone ( ) ______________ Email _____________________________ A/P Contact ______________________________ Title _______________ Phone ( ) ______________ Email _____________________________ Please specify preferred method of invoice delivery Email ____________________________________ Fax ___________________________ Please specify preferred method of statement delivery Email __________________________________ Fax ___________________________ AGREEMENT The undersigned hereby certifies that the information provided on this Dealer Application and Financial Information is true and correct. The undersigned further agrees to be jointly and severally liable for payment of all invoices for products shipped by Seawide, including payment of late fees, finance charges and legal fees which may be owed to Seawide by Dealer. The undersigned represents that the undersigned has read the Dealer Information and Terms in the cover letter signed by Mike Yarbro, the President of Seawide, and on behalf of Dealer, agrees to be bound by such terms and conditions contained in the Dealer Information and Terms cover letter. The undersigned represents and warrants that they have the authority to bind the Dealer. Signature _______________________________________________________________________Title ____________________________________ Print Name _____________________________________________________________Date ____________________________________________ (Please SIGN and PRINT name above. NOTE: Signature Must Be Owner, Partner or Officer) For Office Use Only CUST # _________________________ Date Rcvd _____________ Cust Since _________________Terms or Limit Increase Request? Yes No Initial Terms__________________ Terms______________ Salesperson _______________ Class _________________ Territory ________________ Initial Limit______________ Limit__________ Resale_________ Manager_______________ User ID_______________ Password _____________ CC Customer Salesperson Manager AR Rep Website Avatax


2017 SEAWIDE DISTRIBUTION CATALOG
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