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Section 7.2, Authorized Servicing Dealer &
Manufacturer's Representatives Form |
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Servicing Dealer Information |
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DEALER
NAME: |
Contrax Furnishings |
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DEALER
FEID NO.: |
593710754 |
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MFMP /
SPURS VENDOR NO.: |
[Enter
Dealer's MFMP / SPURS Vendor Number, if Known] |
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STREET
ADDRESS: |
690 NE 23
rd. Ave. |
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CITY,
STATE and ZIP: |
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INTERNET
ADDRESS: |
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TELEPHONE
NO.: |
[Enter
Dealer's Main Telephone Number] |
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TOLL-FREE
NO.: |
(800)
699-7516 |
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FAX NO.: |
(877)
373-0622 |
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Manufacturer Representation |
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MANUFACTURER'S
REPRESENTATIVE NAME: |
[Enter
Manufacturer's Representative Name] |
|
TITLE: |
[Enter
Manufacturer's Representative Title] |
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STREET
ADDRESS: |
[Enter
Manufacturer's Representative Street Address] |
|
CITY,
STATE and ZIP: |
[Enter
Manufacturer's |
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E-MAIL
ADDRESS: |
[Enter
Manufacturer's Representative E-Mail Address] |
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TELEPHONE
NO.: |
[Enter
Manufacturer's Representative Telephone Number] |
|
TOLL-FREE
NO.: |
[Enter
Manufacturer's Representative Toll-Free Telephone Number, if Available] |
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CELL
PHONE NO.: |
[Enter
Manufacturer's Representative Cell Phone Number (Optional)] |
|
FAX NO.: |
[Enter
Manufacturer's Representative Fax Number] |
|
GORAPHIC
AREA OF TERRITORY: |
Entire
state of |
|
NOTES: |
|
|
Note: Please make sure the Ordering
Instructions information provided above matches the MyFloridaMarketPlace
("MFMP") Vendor Registration account information (http://vendor.myfloridamarketplace.com/).
|
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|
PLEASE DUPLICATE THIS FORM ON
ADDITIONAL TABS AS NEEDED |
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Section 7.2, Authorized Servicing Dealer &
Manufacturer's Representatives Form |
|
|
Servicing Dealer Information |
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DEALER
NAME: |
Hertz
Furniture Systems |
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DEALER
FEID NO.: |
22-3795977 |
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MFMP /
SPURS VENDOR NO.: |
[Enter Dealer's
MFMP / SPURS Vendor Number, if Known] |
|
STREET
ADDRESS: |
|
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CITY,
STATE and ZIP: |
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INTERNET
ADDRESS: |
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TELEPHONE
NO.: |
201-529-2100 |
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TOLL-FREE
NO.: |
800-526-4677 |
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FAX NO.: |
800-842-9290 |
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Manufacturer Representation |
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MANUFACTURER'S
REPRESENTATIVE NAME: |
[Enter
Manufacturer's Representative Name] |
|
TITLE: |
[Enter
Manufacturer's Representative Title] |
|
STREET ADDRESS: |
[Enter
Manufacturer's Representative Street Address] |
|
CITY,
STATE and ZIP: |
[Enter
Manufacturer's |
|
E-MAIL
ADDRESS: |
[Enter
Manufacturer's Representative E-Mail Address] |
|
TELEPHONE
NO.: |
[Enter Manufacturer's
Representative Telephone Number] |
|
TOLL-FREE
NO.: |
[Enter
Manufacturer's Representative Toll-Free Telephone Number, if Available] |
|
CELL
PHONE NO.: |
[Enter
Manufacturer's Representative Cell Phone Number (Optional)] |
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FAX NO.: |
[Enter Manufacturer's
Representative Fax Number] |
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GORAPHIC
AREA OF TERRITORY: |
[Enter
Manufacturer's Representative Georaphic Area of
Territory] |
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NOTES: |
|
|
Note: Please make sure the Ordering
Instructions information provided above matches the MyFloridaMarketPlace
("MFMP") Vendor Registration account information (http://vendor.myfloridamarketplace.com/).
|
|
|
PLEASE DUPLICATE THIS FORM ON
ADDITIONAL TABS AS NEEDED |
|
|
Section 7.2, Authorized Servicing Dealer &
Manufacturer's Representatives Form |
|
|
Servicing Dealer Information |
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|
DEALER
NAME: |
YSRG |
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DEALER
FEID NO.: |
20-5156094 |
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MFMP /
SPURS VENDOR NO.: |
[Enter
Dealer's MFMP / SPURS Vendor Number, if Known] |
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STREET
ADDRESS: |
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CITY,
STATE and ZIP: |
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INTERNET
ADDRESS: |
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TELEPHONE
NO.: |
(305)
781-3113 |
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TOLL-FREE
NO.: |
[Enter
Dealer's Main Toll-Free Telephone Number, if Available] |
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FAX NO.: |
(305)
254-8349 |
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Manufacturer Representation |
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MANUFACTURER'S
REPRESENTATIVE NAME: |
[Enter
Manufacturer's Representative Name] |
|
TITLE: |
[Enter
Manufacturer's Representative Title] |
|
STREET
ADDRESS: |
[Enter
Manufacturer's Representative Street Address] |
|
CITY, STATE
and ZIP: |
[Enter
Manufacturer's |
|
E-MAIL
ADDRESS: |
[Enter
Manufacturer's Representative E-Mail Address] |
|
TELEPHONE
NO.: |
[Enter
Manufacturer's Representative Telephone Number] |
|
TOLL-FREE
NO.: |
[Enter
Manufacturer's Representative Toll-Free Telephone Number, if Available] |
|
CELL
PHONE NO.: |
[Enter
Manufacturer's Representative Cell Phone Number (Optional)] |
|
FAX NO.: |
[Enter
Manufacturer's Representative Fax Number] |
|
GORAPHIC
AREA OF TERRITORY: |
Entire
state of |
|
NOTES: |
|
|
Note: Please make sure the Ordering
Instructions information provided above matches the MyFloridaMarketPlace
("MFMP") Vendor Registration account information (http://vendor.myfloridamarketplace.com/).
|
|
|
PLEASE DUPLICATE THIS FORM ON
ADDITIONAL TABS AS NEEDED |
|
|
Section 7.2, Authorized Servicing Dealer &
Manufacturer's Representatives Form |
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|
Servicing Dealer Information |
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DEALER
NAME: |
A.T.D.
American |
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DEALER
FEID NO.: |
23-1921196 |
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MFMP /
SPURS VENDOR NO.: |
[Enter
Dealer's MFMP / SPURS Vendor Number, if Known] |
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STREET
ADDRESS: |
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CITY,
STATE and ZIP: |
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INTERNET
ADDRESS: |
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TELEPHONE
NO.: |
(215)
576-1000 |
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TOLL-FREE
NO.: |
[Enter
Dealer's Main Toll-Free Telephone Number, if Available] |
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FAX NO.: |
(215)
690-3614 |
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Manufacturer Representation |
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MANUFACTURER'S
REPRESENTATIVE NAME: |
[Enter
Manufacturer's Representative Name] |
|
TITLE: |
[Enter
Manufacturer's Representative Title] |
|
STREET
ADDRESS: |
[Enter
Manufacturer's Representative Street Address] |
|
CITY,
STATE and ZIP: |
[Enter
Manufacturer's |
|
E-MAIL
ADDRESS: |
[Enter
Manufacturer's Representative E-Mail Address] |
|
TELEPHONE
NO.: |
[Enter
Manufacturer's Representative Telephone Number] |
|
TOLL-FREE
NO.: |
[Enter
Manufacturer's Representative Toll-Free Telephone Number, if Available] |
|
CELL
PHONE NO.: |
[Enter
Manufacturer's Representative Cell Phone Number (Optional)] |
|
FAX NO.: |
[Enter
Manufacturer's Representative Fax Number] |
|
GORAPHIC
AREA OF TERRITORY: |
Entire
state of |
|
NOTES: |
|
|
Note: Please make sure the Ordering
Instructions information provided above matches the MyFloridaMarketPlace
("MFMP") Vendor Registration account information (http://vendor.myfloridamarketplace.com/).
|
|
|
PLEASE DUPLICATE THIS FORM ON
ADDITIONAL TABS AS NEEDED |
|
|
Section 7.2, Authorized Servicing Dealer &
Manufacturer's Representatives Form |
|
|
Servicing Dealer Information |
|
|
DEALER
NAME: |
Signature
Products |
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DEALER
FEID NO.: |
20-31099822 |
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MFMP /
SPURS VENDOR NO.: |
[Enter Dealer's
MFMP / SPURS Vendor Number, if Known] |
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STREET
ADDRESS: |
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CITY,
STATE and ZIP: |
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INTERNET
ADDRESS: |
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TELEPHONE
NO.: |
(407)
299-0896 |
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TOLL-FREE
NO.: |
(800)
432-6190 |
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FAX NO.: |
(800)
854-8861 |
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Manufacturer Representation |
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MANUFACTURER'S
REPRESENTATIVE NAME: |
[Enter
Manufacturer's Representative Name] |
|
TITLE: |
[Enter Manufacturer's
Representative Title] |
|
STREET
ADDRESS: |
[Enter
Manufacturer's Representative Street Address] |
|
CITY,
STATE and ZIP: |
[Enter
Manufacturer's |
|
E-MAIL
ADDRESS: |
[Enter Manufacturer's
Representative E-Mail Address] |
|
TELEPHONE
NO.: |
[Enter
Manufacturer's Representative Telephone Number] |
|
TOLL-FREE
NO.: |
[Enter
Manufacturer's Representative Toll-Free Telephone Number, if Available] |
|
CELL
PHONE NO.: |
[Enter Manufacturer's
Representative Cell Phone Number (Optional)] |
|
FAX NO.: |
[Enter
Manufacturer's Representative Fax Number] |
|
GORAPHIC
AREA OF TERRITORY: |
Entire
state of |
|
NOTES: |
|
|
Note: Please make sure the Ordering
Instructions information provided above matches the MyFloridaMarketPlace
("MFMP") Vendor Registration account information (http://vendor.myfloridamarketplace.com/).
|
|
|
PLEASE DUPLICATE THIS FORM ON
ADDITIONAL TABS AS NEEDED |
|
| Section 7.2, Authorized Servicing Dealer & Manufacturer's
Representatives Form |
|
| Servicing Dealer Information |
|
| DEALER
NAME: |
Adirondack
Direct |
| DEALER
FEID NO.: |
|
| MFMP
/ SPURS VENDOR NO.: |
[Enter
Dealer's MFMP / SPURS Vendor Number, if Known] |
| STREET
ADDRESS: |
|
| CITY,
STATE and ZIP: |
|
| INTERNET
ADDRESS: |
|
| TELEPHONE
NO.: |
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| TOLL-FREE
NO.: |
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| FAX
NO.: |
(800)
477-1330 |
| Manufacturer Representation |
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| MANUFACTURER'S
REPRESENTATIVE NAME: |
[Enter
Manufacturer's Representative Name] |
| TITLE: |
[Enter
Manufacturer's Representative Title] |
| STREET
ADDRESS: |
[Enter
Manufacturer's Representative Street Address] |
| CITY,
STATE and ZIP: |
[Enter
Manufacturer's |
| E-MAIL
ADDRESS: |
[Enter
Manufacturer's Representative E-Mail Address] |
| TELEPHONE
NO.: |
[Enter
Manufacturer's Representative Telephone Number] |
| TOLL-FREE
NO.: |
[Enter
Manufacturer's Representative Toll-Free Telephone Number, if Available] |
| CELL
PHONE NO.: |
[Enter
Manufacturer's Representative Cell Phone Number (Optional)] |
| FAX
NO.: |
[Enter
Manufacturer's Representative Fax Number] |
| GORAPHIC
AREA OF TERRITORY: |
Entire
state of |
| NOTES: |
|
| Note: Please make sure the Ordering Instructions
information provided above matches the MyFloridaMarketPlace
("MFMP") Vendor Registration account information (http://vendor.myfloridamarketplace.com/).
|
|
| PLEASE DUPLICATE THIS FORM ON ADDITIONAL
TABS AS NEEDED |
|