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Dealer Application & Credit Application

Dealer Information

Thank you for your interest in establishing a Dealer account with MergeWorks. Please take a few minutes to complete the following information.  If you have any questions regarding this application, please call us at (800) 597-1195 or chat with us online. Thank you.


    Section 1

    Company Details

    Legal Name of Firm*

    DBA

    Billing Address*

    City*

    State*

    Zip*

    Phone*

    Website

    Already working with a MergeWorks Rep?*

    YesNo

    Rep Name

    Additional Locations?*

    YesNo

    Location 1
    Authorized to submit POs?

    YesNo

    Address

    City

    State

    Zip

    Phone

    Location 2
    Authorized to submit POs?

    YesNo

    Address

    City

    State

    Zip

    Phone

    Contacts

    Primary Name*

    Email Address*

    Phone Number*

    Sales Name*

    Email Address*

    Phone Number*

    Acknowledgements Name*

    Email Address*

    Phone Number*

    Billing/Invoices Name*

    Email Address*

    Phone Number*

    Type Of Business

    Date Established

    Annual Sales

    Nature of Business

    Do you sell products on your website?

    YesNo

    Do you have a showroom or retail store?

    YesNo

    Do you have an outside sales force?

    YesNo

    What other lines do you carry?

    Terms and Conditions*

    Terms and conditions of MergeWorks (the “Company”). These terms and conditions supersede all previous policies, pricing, discounts, and lead times whether given orally or in writing by Company. All terms and conditions are subject to change at Company’s discretion. The Buyer agrees to abide by all terms and conditions stated below, as modified by Company from time to time in writing.

    MAP Pricing*

    MergeWorks is focused on maintaining high margins for our Dealer network, promoting fair competition across all distribution channels and maintaining brand identity and value. MergeWorks has an established Minimum Advertised Price (MAP) of 35% off List Price for any advertised MergeWorks product. MAP applies only to advertised prices and does not apply to the price at which the products may be sold. Failure to comply with the MAP Pricing Policy may result in the immediate loss of Authorized Dealer status.

    Upload and attach Resale Certificate here*


    Section 2

    Business Credit Application

    MergeWorks offers multiple payment options. Companies who wish to receive credit terms must fill out the credit application below. We utilize a quick credit check system to provide a faster credit approval process.

    Companies who do not wish to utilize credit terms, or who are in the waiting process for credit approval, are offered the ability to prepay their order either by ACH, or by credit card. Please note that credit card payments will incur a 3% convenience fee.

    Credit Application

    Opt Out of Credit Term (order must be prepaid)

    Comp Info

    Dun & Bradstreet Number*

    Credit Limit Preferred

    Name of Business*

    Tax I.D. Number*

    Address*

    City*

    State*

    Zip Code*

    Phone Number*

    Contact Information

    Accounts Payable Contact*

    Phone Number*

    Email Address*

    Trade References

    Upload and attach Reference Sheet here*


    Trade Reference 1

    Company Name*

    Contact Name*

    Phone Number*

    Email Address*

    Account Number

    Trade Reference 2

    Company Name*

    Contact Name*

    Phone Number*

    Email Address*

    Account Number

    Trade Reference 3

    Company Name*

    Contact Name*

    Phone Number*

    Email Address*

    Account Number

    Terms and Conditions*

    I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.

    *

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