WATER D.O.G.

* All fields required *

LAST NAME
FIRST NAME
COMPANY NAME
POSITION/TITLE
ADDRESS 1
ADDRESS 2
CITY
STATE/PROVINCE
ZIP
COUNTRY
PHONE
FAX
EMAIL
WEBSITE
TYPE OF BUSINESS	INC. LLC OTHER
YEARS IN BUSINESS
NUMBER OF EMPLOYEES
OFFICERS
CEO/PRESIDENT
OPERATIONS
MARKETING/SALES
TECHNICAL
NUMBER OF LOCATIONS
NUMBER OF SALES ASSOCIATES
TERRITORY COVERED (Please list)
PRODUCTS SOLD (Please list)
Number of Iron Removal systems sold annually

Number of Iron Removal systems sites for both indoor and outdoor irrigation annually (Flow rates > 10 GPM)

FEDERAL TAX Tax ID#
STATE SALES TAX ID#
TAX STATUS	Taxable Exempt-Resolve Other
DUNN & BRADSTREET
DEALER AGREEMENT	To become a certified WATER D.O.G. WORKS dealer the following dealer requirements must be met: 1. Orders: The dealer’s initial order must be a minimum of (1) IronHunter HD unit. 2. Purchase Order: Will be faxed into our office with your company letterhead. The equipment will be Invoiced upon shipping and will be due Net 10 Days. 3. Training and Certification: Dealer agrees to complete DVD and phone training prior to shipment of product.Upon completion of the trainging program, the dealer will be a certified WATER D.O.G. WORKS dealer. 4. Parts and Service: Dealer will have the opportunity to set-up Iron Hunters HD parts and service capabilities. 5. Technical Support: WATER D.O.G. WORKS will provide the dealer with the highest level of technical support direct from the manufacturer. WATER D.O.G. WORKS will provide a complete product manual, on-call service, to the manufacturer technical support line, and trouble shooting guide. 6. Sales and Promotional Materials: WATER D.O.G. WORKS will provide the dealer with sales and product information material about the Iron Hunter HD product line. We will also feature an on-line dealer locator for consumers to locate and contact certified WATER D.O.G. dealers. 7. Length of Agreement: The WATER D.O.G. WORKS dealer agreement is valid for 12 months unless early termination by written communication is requested. 8. Liability: WATER D.O.G. WORKS will not be held responsible for any lawsuites caused by improper use or installation of products purchased from WATER D.O.G. WORKS. Our standard terms are Net 10 days from the invoice date. We agree to pay interest of 1.5% per month on past due accounts. Failure to adhere to our terms may result in a shipping hold on future orders. I hereby certify that the information set forth here together with all other information submitted in connection with this application is true and correct. I understand that WATER D.O.G. WORKS will rely on this information in extending credit to me and I authorize WATER D.O.G. WORKS to contact and obtain information from the references provided. We fully understand your credit terms and conditions and agree to making proper payments in consideration of extended credit.I agree to the terms above and acknowledge that I am in authority to commit my company to these terms. I understand and agree to all of the above dealer requirements