Dear Customer, We would like to take this opportunity to welcome you to Electro-Matic Products, Inc. In order to set up an account with us, please provide the following information. For quicker processing of your order, we accept Visa, Mastercard and American Express. We encourage credit card payment for initial orders under $1000.00. Billing & Shipping Addresses Preferred method for receiving invoices (e-mail, fax or mail) and contact info Shipping instructions including collect accounts Completed/signed credit application Michigan Sales & Use Tax Certificate of Exemption. Please note that taxes will be charged to Michigan and Ohio customers if this is not provided. Please return your completed information via fax to either Customer Service at 248-615-1573 or Accounting at 248-478-1472. Remit to address: 1588 Reliable Parkway Chicago, il 60686-0015 Physical address: 23409 Industrial Park Ct. Farmington Hills, mi 48335 We have also included some information that you may need in order to set us up in your system as a supplier: w9, iso Registration, Duns# 06-558-4195 Our website, www.electro-matic.com, has more information about our products and services. Please feel free to visit it anytime to get the latest industrial / training / product news. Orders can be sent to us via the following methods: E-mail: ecustomerservice@electro-matic.com Fax: 248-615-1573 Phone: 248-478-1182 and follow the prompts for Customer Service We are excited to announce that we will be launching a new b2b site that will allow customers to check stock, pricing and order status. We value your business and look forward to providing you excellent service in the future. Sincerely, Electro-Matic Products, Inc. Employee Owned Company
ELECTRO-MATIC PRODUCTS, INC. CREDIT APPLICATION Page 1 of 2 Please complete the following application in its entirety. COMPANY INFORMATION Company Name: Address: City: State: Zip: Phone: ( ) Fax: ( ) Company Email Address: Company Affiliates (if any): Invoice Via: Email Fax Mail BUSINESS INFORMATION Please Indicate Legal Status: Sole Proprietor Corporation Partnership Other: Tax ID Number: SIC Code: (or Social Security Number of Individual Owner(s) (Type of Business) Tax Exempt #: (Must Include Copy of Exemption Form/Certifi cate) Number of Employees: Own or Rent Business Building: DUNS #: Length of Time in Business: Length of Time at Location: Estimated Annual Sales: Has Your Company ever gone through Bankruptcy? Yes No If Yes, When and Where? REFERENCES Applicant authorizes seller to contact the fi nancial and trade references listed and any credit reporting agencies to obtain, verify and reverify credit information. Date: Signature of Authorized Offi cer or Owner of the Company Please provide 4 Industry Related Trade References. Name Address Phone # Fax # 23409 Industrial Park Ct. Farmington Hills, MI 48335 P: (248) 478-1182 F: (248) 478-1472 www.electro-matic.com FR-0065 Rev.
ELECTRO-MATIC PRODUCTS, INC. CREDIT APPLICATION Page 2 of 2 Bank Name: Address: City: State: Zip: Phone: ( ) Fax: ( ) Years Account Open: Type of Account: Checking Savings Arbitration Agreement: The parties agree to resolve by binding arbitration all claims and disputes arising from or relating to agreements and transactions, including the validity of this arbitration clause. The arbitration shall be governed by the Code of Procedure of Equilaw s National Forum (NAF). The applicable Code shall be the Code of Procedure in effect at the time the claim is fi led with Equilaw, whose United States administrative offi ce is located at 2124 Dupont Avenue South, Minneapolis, Minnesota 55405, (612) 871-9205. The parties agree to accept service by certifi ed mail, return receipt requested, through the nited Sta es Postal Service, of the Initial Claim Documents which begin an arbitration. Judgement upon the Award may be entered in any court having jurisdiction. Applicant(s) signature attests fi nancial responsibility, ability and willingness to pay invoices in accordance with Electro-Matic Products, Inc., standard terms & conditions or other Company executed agreement stating specifi c terms & conditions. The above information is for the purpose of obtaining credit terms and is warranted to be true. I/We do hereby authorize Electro-Matic Products, Inc., to investigate the references listed pertaining to the company s and/or owner s credit and fi nancial responsibility. Applicant understands that in the event the credit account becomes seriously delinquent requiring the use of other means to collect the outstanding liability, all fees, court costs, legal fees required to obtain payment and, appropriate fi nance charges, may by imposed by the seller upon the applicant. Company Name: Date: Signature: Title: (Person signing must be able to bind the company) (Both Owners must sign in the event of a partnership) RIGHT TO OFFSET At either Party s sole discretion and without prior consent of either Party (or it s affi liate), and notwithstanding anything to the contrary in any other agreement between either Party (or its Affi liate), either Party may deduct or off-set from any amounts that either Party (or its Affi liate) may owe the other Party (or its affi liate), under any other agreement between the Parties (or their Affi liates), any amounts due either Party nder the Agreement. Date: (Authorized Signature) FR-0065 Rev. 23409 Industrial Park Ct. Farmington Hills, MI 48335 P: (248) 478-1182 F: (248) 478-1472 www.electro-matic.com
PRODUCTS & PARTNERS A U T O M A T I O N P R O D U C T S C O N N E C T I V I T Y P R O D U C T S S P E C I A L P R O D U C T S V I S U A L P R O D U C T S Electro-Matic Products is a world leader in the value-added sales, distribution and support of technology-based products and industrial automation solutions since 1969. AUTOMATION PRODUCTS Our Automation Products Group provides everything you need from one source: technology and motion control solutions, a full range of drive and automation technology as well as pre- and after- sales service. Power Distribution Equipment Industrial Controls and Computers Ethernet Switches and Fuses Human Machine Interface Integrated Safety Systems Programmable Controllers Drives, Motion Control Process Automation Automation Software Enclosures R.F.I.D. Climate Control Gear Boxes Encoders and Sensors Wireless Radios and Networks CONNECTIVITY PRODUCTS Our Connectivity Products Group provides global cable-based industrial solutions. With over thirty-six years of experience in the design, manufacturing, and supply of quality industrial cords, connectors and device connectivity solutions, you can count on Electro-Matic to provide quality and reliability. Custom Industrial Cable Assembly Cable Solutions for Industrial & Factory Automation Circular Connectors Rectangular Connectors Cordsets Molded Plugs & Receptacles Solutions for Device Connectivity SPECIAL PRODUCTS Our Special Products Group provides custom value-added products, services and solutions for automation control applications. Our Total Solutions start by providing start-up technical assistance, product selection, design, assembly, and operator training. Terminal Blocks Auxillary Power Supplies LED Lighting Remote Ports Pendants Indicator Banks or Stacklights Palm Button Bars Slip Rings Industrial Computer Stations Robot Harnessing Cable Protection Systems Music Boards Industrial Enclosure Systems Modular Automation Solutions Other Special Customized Assemblies VISUAL PRODUCTS Our Visual Products Group provides visual product solutions that communicate in commercial, retail and industrial environments. Our family of LED/LCD display solutions included solutions for indoor, outdoor and factory floor applications. Electronic Message Centers Process Control Boards Cell Level Andons Marquees Visual Factory Network Solutions Outdoor LED Displays & Signs Time & Temperature LED Displays Indoor LED Displays Window Displays Digital Electronic Media An ISO 9001:2000 Company v i s i t u s o n l i n e a t w w w. e l e c t r o - m a t i c. c o m CORPORATE 23409 Industrial Park Ct. Farmington Hills, MI 48335 P: 248-478-1182 F: 248-478-1472 WESTERN MICHIGAN - SALES OFFICE 8560 Centre Industrial Ct., SW, Suite 6 Byron Center, MI 49315 P: 888-273-6164 F: 616-583-1681 OHIO - SALES OFFICE 2868 Westway Drive, Suite G Brunswick, OH 44212 P: 888-879-1088 F: 330-225-4426
Power Distribution Equipment Industrial Controls Programmable Controllers Drives Motion Control Process Automation Automation Software Machine Vision Sensors Custom Cable Assemblies Drag Chain Cable Hose Assembly Value-added Kiting & Installation Industrial Keyboards and Pointing Devices Industrial Connectors Industrial Enclosure Systems Enclosure Climate Control Power Distribution Systems Indoor LED Displays Programmable Limit Switches Molded Plugs and Receptacles Solutions for Device Connectivity Electrical Design Software Electronic Message Displays Process Control Boards Cell Level Andons Visual Factory Network Solutions Safety Interlocking System Cable & Hose Carrier Systems Fuses, Fuse Blocks & Holders Industrial Varistors Arc Flash and Shock Hazard Assesment Modular Aluminum Extrusion System Cable and Dragchain Assembly Sensor Integration Components Cable Solutions for Industrial and Factory Automation Cable Tray & Cable Management System Long Range Spread Spectrum RF Radios Industrial Connectors Interconnection Products and Systems Photoelectric, Proximity, Limit Switches, Lasernet Weldfield Immune Prox Switches Multi-Network Connectivity Network Interface Cards Servo Gearhead Products Certified Insulated Products Cable Ties Wiring Duct and Wire Labels Industrial Cable Diagnostic tool for PROFIBUS Networks Insulated Hand Tools Personal Protective Equipment Photoelectric Sensors Cables and Cable Accessories Cable Protection Systems Pushbuttons and Palm Switches Pilot Lights Key Operated Switches Sensor Process Connectivity Relay Channel Mounted Terminal Blocks Outdoor LED Displays & Signs Time & Temperature LED Displays Solutions for Electronic Message Centers Cable Management Cable Protection Systems Robot Harnessing Ethernet Connectors Strategically aligned with world-class manufacturers/partners, we provide customers with access to the finest products and innovative solutions. OUR PRODUCTS