Rfq_form Rfq Form
User Manual: rfq_form
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Date:_____________________________ RFQ #: _____________________________
If open line of credit above $5,000.00 is desired, please include a copy of your credit references and your most recent financial
statement. To eliminate delays in processing your request, please answer all questions asked. If you intend to resale online, you
must provide us with your website address.
Products of Interest
Company Name: ________________________________
_
__
_
Federal Tax ID (EIN): ________________________________
_
Buyers Name: ______________________________________
Street: ___________________________________________
City: ______________________ State: ________________
Zip Code: ___________ Country:_____________________
Phone #: ( ) _____________ Fax #: ( ) ___________
Email Address: ____________________________________
Company Website: _________________________________
Check One: Corporation ( ) Sole Proprietor ( )
□ Distributor ( ) □ Retail ( )
□ Online Sale ( ) □ Filling a bid ( )
□ Armed Forces ( ) □ Procurement ( )
□ Government ( ) □ Non Profit ( )
□ OEM ( )
Method of Payment:
□ Term ( ) □ DoD WAWF ( )
□ Credit Card ( )
□ Wire Transfer ( )
□ C.O.D ( )
Product 1: Quantity:_____________ per Order ( ) Per Mounth ( )
Product 2: Quantity:_____________ per Order ( ) Per Mounth ( )
Product 3: Quantity:_____________ per Order ( ) Per Mounth ( )
Product 4: Quantity:_____________ per Order ( ) Per Mounth ( )
________________/_______________/_______________________ /
ETAD ELTIT )EMAN TNIRP( ERUTANGIS
PLEASE FAX THIS FORM
OR EMAIL TO: sales@safety-devices.com
TO: 818.701.9220
Advanced Safety Devices
21430 Strathern St Unit M
Canoga Park, CA 91304
Tel: 818.701.9200
Fax: 818.
701.9220
REQUEST FOR
WHOLESALES PRICING
Company Information Type of Sales
