New Customers - Kamcor

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MINIMUM ORDER $2,000.00

Company
This field is for validation purposes and should be left unchanged.
Company Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Fax Number
Phone*
Sales Rep Name*
Email*
Primary Contact
Cell Phone
Consent*
I agree to the terms
The undersigned hereby certifies that all merchandise purchased will be exempt, for the reason given below, from State, County, or City Taxes, commonly referred to as Sales and/ or Use Tax, Gross Receipts Tax, etc. It is agreed that the undersigned will be responsible for the tax in the event any of such purchases are held to be taxable. This certificate shall be considered a part of each order unless otherwise specified. This certificate shall be good until revoked in writing.
Type of business
Description of merchandise to be purchased
Reason for exception
City or State License*
Owner Name*
Owner Cell Phone*
Date