My@Brand

Business Information

Corporate Name

Doing Business As Name of Firm (if different)

Principal (Owner / Officer) FirstName

Principal Last Name

Principal Title

Principal Phone

Principal Email

Mailing Address

Shipping Address

Same as Mailing Address

Business Phone

Fax

Business Email

Website

Business Type

Year Business Began

Business License Exp.

Insurance Policy Exp.

General Liability Insurance Amount

Field Technician Count

Are you a Union shop?

Accounts Payable

Same As Principal

First Name

Last Name

Phone

Service Contractor's credit line is set at $1,000.00. If a higher limit is needed, please explain:

Referral

How did you hear about us?

Company

Name

Phone

Service Contract

Enter Your Requested Rates

All Rates are Per-Call

Rheem does not contract for hourly rates.

Residential Repair Rate

Residential Replacement Rate

Hybrid/Tankless/Commercial Repair Rate

Hybrid Replacement Rate

Do you currently install Rheem products?

If Yes, approximately how many per-year?

Do you currently install our competitor's products?

If Yes, approximately how many per-year?

Do you service competitor brands?

Number of Years Experience in This Area

Select All Supported Brands/Services

All Brands

Rheem

Ruud

Paloma

Replacement

Service

New Installation

Type:

Commercial

Residential

Tankless

Hybrid

Select All Specialty Work

HVAC

Boilers - DHW

BoilersHydronicSystems

Drains

Other

Acknowledge the following:

I hereby authorize Rheem and its designated agents to conduct a comprehensive review of my background.

I certify that I will conduct a comprehensive background review of all my employees within 30 days.

References and Invoicing

Please provide two Trade / Credit references for major product lines below.

Reference #1

Company

First Name

Last Name

Phone

Fax

Reference #1 Address

Reference #2

Company

First Name

Last Name

Phone

Fax

Reference #2 Address

Invoicing

Please Select Your Invoice Preferences

Receive Invoice Mail

Receive Invoice Fax

Receive Invoice Email

Special Billing Requirements

Is P.O. Number Required?

Contracted Service Area

Notice

Please list below only zip codes you will cover at the contract rate. Before service is rendered outside the zip codes below, please call 877-882-0682 for authorization. Please separate zip codes with a comma. (12345, 22222, ...)

Contracted Service Area

Terms And Conditions

Our invoices are dated the day of shipment.

Rheem's present payment terms for Service Contractors are Net 30 days. Any overdue balance may be subject to a service charge at the rate of one and one-half percent (1.5%) per month (18% annum), or at the legal rate of interest permitted by law. If paperwork is not submitted in a timely fashion any or all labor credits can be applied to the account to clear any or all past due balances.

Remarks

I acknowledge that I have read and understand the above terms.

You Are Done!

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