1400 Everman Parkway, Suite 156
Fort Worth, TX 76140
817-293-3018
800-433-2212
817-293-7570 Fax

Dealer Application
Company Name
Street Address
City State Zip
Mailing Address
City State Zip
Telephone No. Fax No.    
Email Address
Number of Branch (add additional sheet listing branch locations)
Federal Tax ID # D&B #    
           
Forklift Dealer: Brands 
Caster House          
Pit Levelers: Brands 
SIC Code NAIC Code    
           
Sales Volume D&B Rating    
Date Started        
Contacts:          
President Controller    
Sales Manager A/P    
Credit References:          
  Company City Telephone Fax Contact
1.
2.
3.
Bank:
How did you learn about Bluff?
Advertising Establishing Dealer Saw Product
Salesman Contact Internet Experience w/other Bluff Dealers
Other

Attorney Fees *
If any default is made in payment of amounts due for the sale of goods hereunder, and the account is placed in the hands of any attorney for collection, Buyer agrees to pay Seller's reasonable cost of collection, including reasonable attorney's fees, not to exceed the amount allowed by any applicable statute.
Signature Title    
Date        
Please include a copy of your sales tax certificate. Failure to receive a sales tax certificate will delay the approval process.

 

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