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Poly Vinyl Creations Poly Vinyl Creations
Fence Den

Dealer Application

Poly Vinyl Creations, Inc., Inc. permits you to fill out and sign our dealer's application using this web site. This Federal E-Sign Disclosure and Consent describes Poly Vinyl Creations, Inc., Inc.'s process so that you can decide whether you wish to continue with your request through our web site. If you wish to print out and fill out and fax to 727-857-9304 or mail to 11313 State Road 52, Hudson, FL 34669, you may also do so. Please read this page carefully and print a copy of this page for your records.
Electronic Signature and Electronic Delivery of Disclosures and Notices
By clicking in the box marked "I agree" at the bottom of this page, you consent to use electronic communications, electronic records, and electronic signatures rather than paper documents for the forms provided on this web site. Those forms include

  • The Letter of Authorization permitting Poly Vinyl Creations, Inc., Inc. to run personal and business credit reports, contact credit and bank references, check Better Business Bureau Records and any other means to determine both your account eligibility as well as potential credit you may be seeking. Please note that filling out this paperwork DOES NOT guarantee an account will be opened with or without credit;
  • All quote, order and invoice requests that are made electronically via your company;
  • Responses to communications from you;
  • Other documents relating to your account with Poly Vinyl Creations, Inc., Inc.; and
  • All changes and updates to these disclosures, notices, and documents.

You understand that your electronic signature is legally binding, just as if you had signed a paper document. Your consent to use electronic signatures and documents applies only to materials related to your request to do business with Poly Vinyl Creations, Inc., Inc.
Paper Signature and Paper Delivery of Disclosures and Notices
If you prefer to use paper signatures, you may instead print a copy of the full dealer's application (attached), fill it out, and return it to us by mail or by facsimile to 727-857-9304. You understand that Poly Vinyl Creations, Inc., Inc. will not begin to process your request until it receives all documentation.
You have the right to receive a paper copy of the disclosures, notices, terms and conditions, and other communications described above. There is no cost to receive paper copies of any electronic records. If you wish to receive a paper copy, please send a request with your name, mailing address, daytime telephone number, and the document you wish to receive to one of the following:

  • Email: marketing@polyvinylc.com
  • Toll-free: 800-780-3362 (US) or 727-857-9618 (International)
  • Mail: Poly Vinyl Creations, Inc., Inc.

Attn: Accounting Department
11313 State Road 52
Hudson, FL 34669 USA
System Requirements
In order to use electronic signatures and to receive electronic communications, you must have

  • a personal computer or other device that can connect to the Internet;
  • an e-mail address;
  • a web browser;
  • software that enables you to receive and view Portable Document Format (PDF)
    files, such as Adobe Acrobat Reader (available for a free download at http://get.adobe.com/reader/)

Withdrawal of Electronic Acceptance of Disclosures and Notices
You may withdraw your consent to receive electronic communications at any time. If you wish to do so, please notify us at the addresses above and provide your name, mailing address, daytime telephone number, and a description of the type of transaction from which you are withdrawing your consent.

Instruction: All sections must be completed (3 pages). Missing information will delay processing of application. Sign appropriate sections of application. Return original application before first order will be shipped.

Company Information
Company Name DBA
* Main line of business    
*Mailing Address *City * State *Zip Code
*Shipping Address *City * State *Zip Code
* County of business    
* Means of Unloading (Pickup at PVC Location, Forklift, Bobcat, hand unload (we have limitations here), Other (Describe)
*Phone Fax
Cell Phone * Email
Federal Tax ID# * Years in Business
* Contact Person Title Cell
* Please list all authorized purchasers
Purchase Order Required?
Credit Limit Requested:    
Even if you are requesting COD, we still run references, background and credit checks, and banking information.
Estimated Monthly Volume
Company is:    
Are you subject to State Tax?    
Tax Exemption # (if applicable)  
We only collect sales tax in the states where we have manufacturing locations. Currently this includes Florida, Georgia, and North Carolina.
TAX EXEMPTION FORM MUST ACCOMPANY APPLICATION OR TAX WILL BE CHARGED TO YOUR ACCOUNT. You can also fax it in to 727-857-9304 or e-mail it to marketing@polyvinylc.com.
Add Tax Exempt Form:    
OWNERS, PRINCIPALS, GUARANTORS (AT LEAST 1 REQUIRED)
If you are a partnership we must have all partners fill out the application. If you are an LLC, we need all managing members to sign the dealer's application. In most cases, only the official owners can sign this section.
Title *Name *SSN *Home Address
*City * State * Zip * Phone
Title *Name *SSN *Home Address
*City * State * Zip * Phone
Title *Name *SSN *Home Address
*City * State * Zip * Phone
*Have any of the principals or owners filed for bankruptcy?
If so, please describe:
*Have any of the principals or owners had a judgment entered against them?
If so, please describe:
*Have any of the principals or owners been convicted of a felony or anything relating to fraud?
If so, please describe:
*Have any of the principals or owners owned other companies prior to this one that are no longer in business?
If so, please fill out:      
Company Name City State Date Business Closed
Company Name City State Date Business Closed
Company Name City State Date Business Closed
INDUSTRY TRADE (SUPPLIER) REFERENCES (AT LEAST 2 REQUIRED)

*Company Name

*Phone

Fax

Acct #

 

 

 

 

 

 

 

 

 

 

 

 

BANK REFERENCES
*Bank Name: * Acct # * Phone * Fax
BUSINESS LICENSE
Please attach copy of all appropriate business licenses and trade certifications. We only sell to licensed businesses and to the trade in which you are involved. You can also fax it in to 727-857-9304 or e-mail it to marketing@polyvinylc.com.
CREDIT RELEASE
Date and at least one signature is required.
Date:
* Signature:
Signature:
Signature:


*CREDIT RELEASE: I, we, hereby authorize banks, trade references, financial institutions and credit reporting agencies the right to release credit information to Poly Vinyl Creations, Inc., Inc. The undersigned understands they give Poly Vinyl Creations, Inc., Inc. the right to investigate both business and personal credit history for account decisions.

GENERAL: Each business must submit an application for an account with Poly Vinyl Creations, Inc., Inc. to be able to purchase materials.  They can apply for a credit account or a COD account. Submittal of an application does not guaranty an account to be opened. An account is not opened until an approval letter is sent out. Poly Vinyl Creations, Inc. reserves the right to modify this application, terms of the application and the account, and status at any time without notice.

PROMISE TO PAY: The account agrees to pay in US funds for all purchases, late charges, return check charges, and under charges in this agreement incurred by the account including any collections costs, court costs and reasonable attorney fees.
CREDIT LINE: Based on your credit history and request for credit, you may be issued a credit line with Poly Vinyl Creations, Inc., Inc. Standard credit terms are generally 30 days. This may be increased, decreased, or revoked at any time based on your payment history with Poly Vinyl Creations, Inc., Inc.
FINANCE CHARGES: 1.5% finance charges per month are applied on all accounts more than 30 days past due or the maximum allowed by State law. These are legally assessed and billed charges on all past due invoices.
RETURN CHECK FEE: Any dishonored check or returned check will be assessed a $25 fee or 5% of the value of the check, whichever is greater or the maximum penalty allowed by the laws of the state the check was presented to Poly Vinyl Creations, Inc., Inc. Thus if the check was mailed in to one of the offices and deposited in that county, then even if the check originated from another state, it will be prosecuted in the county in which it was presented.
ARBITRATION: Applicant(s) agrees to pay all costs of collection incurred by Poly Vinyl Creations, Inc., Inc. including reasonable attorney fees and expenses, should a default in payment or any obligation of the Applicant(s) occur.
CHANGE IN TERMS: Poly Vinyl Creations, Inc. reserves the right to change terms, conditions, services or features of your account or this agreement at any time. As time allows, we will always try to give 30 days’ notice for any change unless an immediate change is necessary such as change in account status due to continuing late payments or inactivity.
CANCELLATION OF ACCOUNT: All accounts with no purchase activity for 6 months will become inactive in our system and any credit previously given will be revoked. Any account with no activity for 12 months will be closed and will have to re-apply for an account.
HOLD HARMLESS: Poly Vinyl Creations, Inc., Inc. makes no warranties, express or implied, including without limitation, warranties as to merchantability, or fitness for a particular use or purpose and shall not be liable for such. Any contradictory statement made by an employee of Poly Vinyl Creations, Inc., Inc. shall have no effect. Poly Vinyl Creations, Inc., Inc. will help but shall not be held responsible for any product defects, manufacturer’s shipping defects, etc. in manufacturing.
TITLE OF PROPERTY: Title to all material shall remain Poly Vinyl Creations, Inc., Inc. until the product is paid for in full and retains lien rights as applicable by law.
LIEN RIGHTS: Poly Vinyl Creations, Inc., Inc. reserves the right to request at any time where product is being installed in order to protect their lien rights.
DELIVERY: All items are FOB Poly Vinyl Creations, Inc., Inc. Invoices are to be paid from the delivery ticket (invoice). Any problems with delivery are to be notated at time of delivery and Poly Vinyl Creations, Inc., Inc. business office must be notified within 24 hours of delivery of any discrepancy. UPS and common carrier deliveries have 3 days to be notified of problems with delivery. This insures the problem is corrected immediately and tracked. Poly Vinyl Creations, Inc., Inc. reserves the right to refuse to honor any discrepancy that is not acknowledged to Poly Vinyl Creations, Inc., Inc. in a timely fashion.
CHANGE OF OWNERSHIP: It is the responsibility of the current owner to provide to Poly Vinyl Creations, Inc., Inc. in writing of any change in ownership, purchasers, etc. If selling a business, Poly Vinyl Creations, Inc. must be notified at least 30 days prior to the sell of the business to change the account and secure all payments on account. It is the owner’s responsibility to verify Poly Vinyl Creations, Inc. has this information.

COMMITMENT TO PAY: The “Guarantor,” in consideration for an account with Poly Vinyl Creations, Inc., Inc. certifies the truthfulness and veracity of the this application and bind themselves to the faithful payment of all amounts purchased or now owing, by Guarantor(s), or any other person, firm, or corporation for their benefit. The guarantor hereby personally guarantees the payment by Applicant(s) to Poly Vinyl Creations, Inc., Inc. of all amounts due, and from time to time hereafter (“Liabilities”) from Applicant(s) to Poly Vinyl Creations, Inc., Inc. Guarantor expressly waives notice from Poly Vinyl Creations, Inc., Inc. of its acceptance and reliance on this personal guaranty, notice of sales made to Applicant(s), and notice of default by Applicant(s). 

DEFAULT OF PAYMENT: In the event of a default by Applicant(s)(s) on its obligations to Poly Vinyl Creations, Inc., Inc., Poly Vinyl Creations, Inc., Inc. may proceed directly to enforce its rights hereunder and shall have the right to proceed first against Guarantor, without proceeding with or exhausting any other remedies it may have. The undersigned further agrees that to the extent that Applicant(s) makes a payment or payments to Poly Vinyl Creations, Inc., Inc. which payments, or any part thereof, are subsequently invalidated, declared to be fraudulent or preferential, set-aside or required to be repaid to Applicant(s), its estate, trustee, receiver, and any other party under any bankruptcy law, federal law, common law, or equitable cause, then to the extent of such payment or repayment, the Liabilities or portion thereof which has been paid, reduced or satisfied by such amount so repaid shall be reinstated as of the date such initial payment, reduction or satisfaction occurred. The undersigned hereby individually and personally guarantees any and all debts incurred by the above business and we agree that the Seller (Poly Vinyl Creations, Inc.) retains title to all goods until payment is made in full. In the event of litigation, all parties agree that the venue shall be determined by Poly Vinyl Creations, Inc. Corporate Office and may include litigation at any of its branch locations. All parties agree to waive any right to trial by Jury. Poly Vinyl Creations, Inc., Inc. shall be entitled to reimbursement for all collection costs, court costs, interest and reasonable attorney fees through appeal and post judgment proceedings.

AUTHORIZATION OF PURCHASES: Purchases and/or deliveries are herewith authorized to be made without signature.

NOTICE TO THE BUYER: Do not sign this agreement before you read it fully. You are entitled to a copy of the agreement you sign upon request. The seller retains a security interest in the subject matter of this agreement. You may at any time pay the full amount due.
PRIVACY POLICY: Poly Vinyl Creations, Inc.  will collect, use, retain and disclose your personal information to provide you with information on Poly Vinyl Creations, Inc. and its associated products and industries; to communicate with you about Poly Vinyl Creations, Inc.’s products and services and other items (including the products and services of third parties) that the Poly Vinyl Creations, Inc. believes that you may be interested in. Poly Vinyl Creations, Inc. will never sell its contact lists to any third party but does sometimes promote industry-related events to its customers in that related industry.
*I have read and agree to the Terms & Conditions
By clicking “I agree” you are indicating that you have read and agree to the above Terms of Use and Privacy Policy.

 

* Terms and Conditions Signature Signature Signature
SUPPLEMENTAL INFORMATION FOR DEALER’S APPLCATION
In order to maintain the integrity and high service to our dealer network, we have a few follow-up questions for you. We realize that this will take a little longer but we want to insure that we form a strong relationship with our dealers offering the best in service that we can. None of the questions will preclude you from being a dealer but they help us look at the markets we are dealing with and do what is best for both you and our company.

Please answer the following questions and return to us to finish processing your application:
Products lines you plan to carry (please list all that apply, i.e. Vinyl Fence, Vinyl Deck, Vinyl Railing, Vinyl Garden Products, D&D Hardware, Aluminum Fence products, Steel Fence Products, Quick Rock, CNC Routing Machine, Aluminum Railing, Simtek Simulated Stone Wall)

What is your estimated monthly purchase volume?  
What are your total annual sales of your company?  
Does your company have a storefront/ showroom?  
Is your business located in:  
*** please note that we can only deliver to locations where our DOT rated trucks are allowed to deliver so if you are in an area that our trucks cannot safely and legally deliver to, you will incur additional delivery expense or be referred to another distribution avenue that can better meet your needs of delivery
How do you plan to unload the material at the time of delivery?
What do you look for in a wholesaler/distributor supplier?  
 
What is your company’s territory? (How many miles will you travel for a project)?  
 
Do you have a web site? If so what is the address:
Please list all contacts you would like in our database
  • Name
  • Position
  • E-mail
  • Cell Phone
  • Daytime Phone
  security code