TERMS & CONDITIONS: AS agreed with Coop,  No returns without pre-authorization.

Dealers who are members of Ace Hardware, Do It Best Corporation, House Hasson, Orgill

 and/or TRUE SERVE can select to be billed and dropped shipped by providing information below, including their ID billing information:

Business name    Contact Person 

Shipping Address  

City    State     Zip Code

Phone number      Fax number

Corporation, Partnership, OR Sole Owner 
Type of Business

                  Ace Hardware ID                                                   Do It Best Corporation ID     
               House Hasson ID              Orgill ID           True Serve ID 

We hereby AGREE to the  TERMS & CONDITIONS offered and authorize AFAB Distribution and/or Brown _USA to
Drop ship with third-party billing PROVIDED ABOVE.

Name of owner, partner and/or officer
Title      Date 
 

TERMS & CONDITIONS: NET 30 DAYS with APPROVED CREDIT, No returns without pre-authorization.

Business name    Contact Person

Billing Address 
City     State    Zip Code

Shipping Address  
City    State   Zip Code
Phone number      Fax number 

Corporation, Partnership, OR Sole Owner 
Type of Business
Do you Own, Rent OR Lease business location(s)?
Any Judgments and/or Litigations Pending? Yes or No      Years in business     # of Locations
Accounts Payable Contact Person     Phone number  

Bank Reference
BANK name              Contact Person   
Address                     Account number  
City                             State      Zip Code
Phone number         Fax number           

Trade References
Business name        Contact Person   
Address                     Account number  
City                             State      Zip Code
Phone number         Fax number           

Business name        Contact Person   
Address                     Account number  
City                             State      Zip Code
Phone number         Fax number           

Business name        Contact Person   
Address                     Account number  
City                             State      Zip Code
Phone number         Fax number           

We hereby AGREE to the TERMS & CONDITIONS offered and authorize AFAB Distribution and/or Brown _USA to legally obtain whatever
 information is necessary, including contacting the above references, to determine our eligibility for an open credit line.

Name of owner, partner and/or officer
Title      Date