Optima Lighting Inc. - The Art and Technology of Lighting


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Dealer Application

Dealer Application Form

Date:

Credit Line Requested:

None (C.O.D Cash or Certified

*C.O.D Company Check

*Line of Credit $

Registration Information:
Your e-mail address*:
Reenter e-mail address*:
Choose a password*:
Reenter password*:

BUSINESS PROFILE:
Company Name*:

First Name*:

Last Name*:

Legal Address*:

City*:

State*:

ZIP Code*:

Country*:

Telephone*:

FAX:

Shipping Address:

I have a Different Shipping Address.

Retail Sale Tax Exemption #:

please email a copy of tax exemption form at sales@optimalighting.com

In Business for how long? *:

Less than 3 Years

3-6 years

more than 6 years

please check which best describes you business*:

Incorporated

Proprietorship

Partnership

If you selected Incorporated, please provide the following: Click here if same as above.

Exact business legal name*:

President:

Address*:

City*:

State*:

ZIP Code*:

Country*:

TRADE REFERENCES:

Three (3) trade references from the pro sound and light industry are required. (If your company has already designed a trade reference sheet that may be submitted in place of the next few questions.)

Do not include any of the following as trade references: custom brokers, credit card companies, office supply companies, utility companies, shipping companies or printing companies.

Reference#1*
Company Name*:
Address*:		City*:

State*:

ZIP Code*:

Country*:

Telephone*:

Fax#:

Contact Name*:

Reference#2*
Company Name*:
Address*:		City*:

State*:

ZIP Code*:

Country*:

TelePhone*:

Fax#:

Contact Name*:

Reference#3*
Company Name*:
Address*:		City*:

State*:

ZIP Code*:

Country*:

TelePhone*:

Fax#:

Contact Name*:

BANK REFERENCES:

1) Name of Bank*:

Street Address*:

City*:

State*:

ZIP Code*:

Country*:

Telephone*:

Fax#:

E-Mail:

Contact Name*:
Account # *:

2) Name of Bank:

Street Address:

City:

State:

ZIP Code:

Country:

Telephone:

Fax#:

E-Mail:

Contact Name:
Account #:

APPLICANT’S SIGNITURE ATTESTS FINANCIAL RESPONSIBILITY, WILLINGNESS AND ABILITY TO PAY OPTIMAS INVOICES IN ACCORDANCE WITH THE TERMS AGREED.

The above information is herewith submitted for the purpose of obtaining dealer status with Optima Lighting and I hereby certify the information to be true. I/we authorize Optima Lighting to investigate any of the above information or references submitted.

Principal full name*:
Principal Signature*:
Principal Title*:		Date:

*If you selected C.O.D company check or line of credit in the credit line requested question please email a copy of principal driver’s license at sales@optimalighting.com for approval.

please allow 2-3 weeks for processing

Dealer Terms and Conditions of Sale

LIMITED WARRANTY                        
1.    All lighting products come with 1-year parts and labor limited warranty.                        
2.    Warranty does not include bulbs, misuse, improper voltage and use of liquids not manufactured by Optima Lighting.                        
TERMS AND CONDITIONS                        
1.    Design, prices and specifications subject to change without notice.                        
2.    Units and weights are subject to change.                        
ORDERING                        
1.    Minimum order: $100 NET, a service charge of $5.00 will be added to any order totaling less than $100.00                        
2.    New accounts: C.O.D. for the first 2 orders, payable by cashier’s check, money order, or a credit card. Applications for credit will then be reviewed for C.O.D. company check or an open account.                        
3.    Any account refusing an order will automatically be put on a REPAY PROGRAM. The account will be responsible for any freight charges. Even if the order was initially sent prepaid.                        
4.    Any account bouncing a check will be put on a COD/CASH ONLY basis. The account will be responsible for $20.00 charge for each bounced check.                        
SHIPPING                        
1.    Shipping: FOB- Long Island City, New York                         
2.    Freight: We will select a carrier unless noted on your purchase order. All shipments go UPS ground. Any air shipments are send freight collect on your account. The carrier is not our responsibility. They are working on your behalf. To insure you receive the service you require, please note your selected carrier.                        
RETURNS                        
1.    The dealer or end user must call or fax for a return authorized number between the hours of 9:00am-6:00pm Mon-Fri Eastern time. All returns will be repaired and returned.                        
2.    All merchandise returns for repair are to be shipped freight (pre-paid) in original carton with original packing materials. Any packages arriving COD will be refused. The return authorized number must be visible on the outside carton.                        
3.    A copy of the sales receipt must be included for product to be repaired under warranty. If the repair is not covered under warranty and the repair cost exceeds $40.00, the customer will be called before the proceeding with the repair for approval.                        
4.    Optima Lighting Co will not return repaired merchandise to customer by priority service. If the customer wishes the merchandise sent back to them by priority Service at their expense, the customer must inform Optima Lighting by including a request in writing with the item to be repaired.                        
5.    All non-warranty repairs are covered under 90 day’s warranty.                        
6.    No COD shipment will be accepted and no call tags will be issued for merchandise return for repair.

I agree to the Dealer Terms and Conditions of Sale

Fields marked with an asterisk * are required.

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Become a dealer

Dealer Application Form

Registration Information:

BUSINESS PROFILE:

TRADE REFERENCES:

BANK REFERENCES:

Dealer Terms and Conditions of Sale