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R&R Surface Protectors, Inc.
Distributor Credit Application Form
*Upon approval of credit application, company will be granted NET 30 Terms.
How did you or your company hear about R&R?
*
Please select one
Return Customer
Referral
Google (or other search engine)
ARA
Tradeshow
LinkedIn
Facebook
Twitter
Instagram
Email Marketing
How will your company place orders with R&R?
*
Please select one that will be used at least 50% of the time.
Online (R&R Customer Portal)
Phone
Email
Smartequip
Does your company use Smartequip?
*
Please select one
Yes
No
Not yet, but plans to
COMPANY INFORMATION
Company Name:
*
Address:
*
City:
*
State / Province:
*
Postal / Zip Code:
*
Phone:
*
Email:
*
Year Business Started:
*
FEIN:
*
Business Type:
*
C Corporation
S Corporation
Limited Liability Company
Sole Proprietor
Resale Certificate No.:
DUNS No.:
DUNS Rating:
CONTACT INFORMATION
Principal First Name:
*
Principal Last Name:
*
Title:
*
Phone:
*
Email:
A/P First Name:
*
A/P Last Name:
*
A/P Title:
Phone:
*
Email:
*
BANKING INFORMATION
Bank Name:
*
Account No.:
Bank Contact:
*
Phone:
*
Email:
TRADE REFERENCES
Company (1):
*
Contact:
*
Contact Title:
Phone:
*
Email:
Company (2):
*
Contact:
*
Contact Title:
Phone:
*
Email:
Company (3):
Contact:
Contact Title:
Phone:
Email:
TERMS & CONDITIONS
By submitting this application, you, your company and all representatives of your company, agree to the following TERMS & CONDITIONS.
R&R's approved Distributors will have standard payment terms of Net 30 Days.
All R&R Distributors must provide/upload a completed R&R Credit Application, current W-9, and copy of their Resale License.
Past Due account balances may cause an account to be placed on a credit hold and will require payment at time of order.
R&R Surface Protectors, Inc. reserves the right to refuse shipment of orders to any account with a past due balance.
Custom products are non-returnable & non-refundable.
Stock items may be returned in original packaging within 30 days from invoice date.
All returns are subject to a 15% restocking fee.
Credit Memos are issued upon receipt and inspection of returned items.
Terms and Conditions are subject to change without notice.
W-9
Upload current signed W9
Choose file
or drag & drop here
SIGNATURE:
*
Must be authorized to enter agreements on company's behalf
Date
FOR R&R USE ONLY
PRICE LEVEL
*
Standard
Authorized
Trusted
Preferred
VIP
RETAIL
Submit
Your application was successfully sent!
You will receive an email with your application status within 48 business hours.
If you need to place an order immediately, please call 877-847-3178.
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