Car Candy - Distributer Application

Step 1 of 5

Complete the Following
Thank you for your interest in becoming a distributor of CarCandy Automotive Detail Products. We seek partners who are interested in actively promoting and selling our products. To initiate our review process, please complete the attached forms and supply the additional information requested.
Forms to Complete:

1. Credit Application

2. The Distributor Information Form: This form helps us understand your business, the means you use to promote and sell products, and the timing of materials we would need to help you with promotion.

Additional Materials Needed:

1. Business Registration Certificate (W9): You must be a registered business.

2. Tax Exemption Certificate: If you apply for tax-exempt status, you must supply Ultra-Look Corp. with a copy of your 2018 Sales Tax Exemption Certificate for shipments within the state of Florida.

Confidential Credit Application
Date*
Month
Day
Year
Credit Line Requested*
Firm Name*
Type of Business*
- Ownership
- Corporation
- Partnership
- Proprietorship
- Other
State where Incorporated*
Date Incorporated*
MM slash DD slash YYYY
Company Email*
Shipping Address*
Street Address City State ZIP Code
Billing Address Same as Shipping Address?
- Yes
Billing Address*
Street Address City State ZIP Code
Phone*
Accounts Payable Contact*
Sales Tax Number*

Please send copy of certificate to [email protected]

Credit Application Continue
Owners Name*
First Last
Phone*
Billing Address*
Street Address City State ZIP Code
Trade Credit References
1. Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
2. Name
First Last
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
3. Name
First Last
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

BANK REFERENCE
Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Account #*
Does this company do business under any other name?*
I verify that, under the pains and penalties of perjury, the above statements are material representations and true and correct and are given for the purpose of obtaining the extension of credit by seller. In the event credit is extended, the undersigned agrees to the following: (1) To pay for all purchases pursuant to the terms of seller’s invoices and those contained herein, (2) To pay seller a delinquency charge of 1 1/2% per month on any amounts remaining unpaid 30 days after the date of invoice, (3) To pay seller reasonable attorney’s fees, which is agreed to be not less than 25% of any outstanding obligation, and costs incurred by the seller in connection with the enforcement of collection of any obligation of the undersigned to seller, (4) To pay all sums due to seller at its address in Polk County, Florida, such county being agreed upon as the county of venue for any suit brought by either party hereto against the other. I represent and warrant that I have read this application in its entirety, and I am fully aware of the consequences hereof:
Electronic signature of Owner*
Printed Name*
Title
Date*
PERSONAL GUARANTEE: In consideration of credit being extended by Ultra-Look Corp. to the above named applicant for merchandise to be purchased whether applicant be an individual or individuals, a proprietorship, a partnership, a corporation, or other entity, the undersigned guarantor or guarantors each hereby contract and guarantee to Ultra-Look Corp. the faithful payment, when due, of all accounts of said applicant for purchases made. The undersigned guarantor or guarantors each hereby expressly waive all notice of acceptance of this guarantee, notice of extension of credit to applicant, presentment, and demand for payment on applicant, protest and notice to undersigned guarantor or guarantors of dishonor or default by applicant or with respect to any security held by Ultra-Look Corp. extension of time of payment to applicant, acceptance of partial payment or partial compromise, all other notices to which the undersigned guarantor or guarantors might otherwise be entitled and demand for payment under this guarantee. Any revocation of this guarantee shall be in writing and delivered to Ultra-Look Corp.
Electronic signature of Owner*
Printed Name*

Distributor Information Form
1. Company established date:*
2. Primary customer type and market(s) are?*
3. Which of the CarCandy products do you wish to distribute?*
4. Do you currently distribute other brand(s) of chemicals? If so, which brand(s)?*
5. What is your geographic distribution territory?*
6. Do you have inside/outside sales representatives? If so, how many?*
7. What is your business model? Retail Storefront/Online/Delivery Trucks etc?*
Please make sure that all information provided above is correct and factual. Once the form is complete, all information listed will be kept strictly confidential between the company applying and Ultra-Look Corp. It shall not be released to any third party.
Company Name
Applicant Name*
Electronic applicant Signature*
Date*
MM slash DD slash YYYY

Step 1 of 5

Complete the Following

Confidential Credit Application

Credit Application Continue

Trade Credit References

BANK REFERENCE

Distributor Information Form

Contact

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