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Become a Dealer for Emergency Zone Products Become a Dealer for Emergency Zone Products
Please fill out the form below to become a dealer of Emergency Zone products.
Company Information
Company Name:
Years in Business:
Tax ID Number:
Seller Permit Number:
Company Website Address:
Retail Store, URL, or Website where products will be sold:


Shipping Address
Street Address:
City:
State/Province:
Zip Code:


Billing Address
Street Address:
City:
State:
Zipcode:


Contact Information
Contact Person:
Contact Position:
Phone Number:
Fax Number:
E-Mail Address:
Verify Security Code
Type Security Code Here:  * Verify Security Code <- Security Code

(1) I hereby certify that the business named above holds a valid seller’s permit issued pursuant to the Sales and Use Tax Law. The products which shall be purchase from Emergency Zone will be resold; however, if in the event any of the products are used for any purpose other than retention, demonstration or display while holding it for sale in the regular course of business, it is understood that I am required to report and pay for the sales/use tax measured by the purchase price of such property.

(2) I agree not to use any information obtained through its relationship with Emergency Zone in a manner that competes with Emergency Zone. This includes but is not limited to pictures, pricing, customer lists, proprietary information, and promotional materials. Emergency Zone reserves the right to terminate its relationship if this information is used inappropriately.

(3) Unless a NET 30 credit line is extended, all purchases must be paid for before shipment. This can be done by credit card or money order.

(4) Any product purchased may be returned only with prior written consent of Emergency Zone, LLC. All retuned shipments will be accepted within 45 days of receipt of goods. All returns are subject to a 10% restocking fee and the purchaser shall pay all freight or shipping costs necessary to return the product to Emergency Zone, LLC.

By submitting this form, I attest that the information above is correct and I agree to the Terms and Conditions of this web site.