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WHOLESALE/ COMMERCIAL  ACCOUNT APPLICATION

To qualify for a Wholesale/ Commercial account your Company must require our products on a regular basis or in bulk.

Business profiles include fleets (i.e. energy companies, contractors), auto dealers, parts stores, automotive jobbers, body shops or similar related businesses.

Upon approval, your Company will receive on-going price discounts off our products.

We provide nationwide same-day or next-day delivery/shipping on most orders, to all 50 states.

Most Colorado customers (including Cheyenne, WY) are eligible for next-day shipping rates beginning at $8.92 per order. Orders also may be picked up at our location.

 
Please complete and submit the on-line form below. If your Company has a standardized form, you may fax it to: 303.698.9879.

We will contact you immediately to establish your account. All information provided will remain strictly confidential.

Please call our customer service department with any questions you may have. 303.698.9800 local • 800.545.4605 toll free

Thank you.

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Company Name:
Phone #:
Fax #:
Email:
Website:
Shipping Address:
City:
State:
Zip:
Billing Address (if different):
City:
State:
Zip:
Business Description:
Number of Employees:
Parent Company (if franchise or subsidiary):
Principal's Name:
Address:
City:
State:
Zip:
 Store Front?  YesNo
Installation Shop?  YesNo
 Do You Rent or Own Building  RentOwn
 Payment Terms Requested  Credit Card

COD (Company Check Only)*

Net 30 Days WAC**
Sales Taxable? (Colorado Customers Only)   YesNo
Colorado Sales Tax License # (if non-taxable):
Expiration Date:
Currently Purchasing From:
How Did You Hear About Us?:
Your Name:
Your Position With Company:
Additional Comments or Questions:
* We will provide you with a Bank Reference Form which must be completed.
** We will provide you with a Credit Application and Bank Reference Form which must be completed.
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