Authorized Dealer Program Dealer Application by dfffwwwkdfi

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									Authorized Dealer
Program
Dealer Application
The attached Dealer Application is a prerequisite of consideration for the
Mace ® Authorized Dealer Program. This information and the Dealer profile
(Appendix A) must be submitted with this completed application even in the
event that you had previously completed a Mace ® credit application.


1      Minimum Dealer Requirements
           • Established credit history with security suppliers
           • Must have been responsive to all inquires and complaints received from the Better
2            Business Bureau and/or Attorney General

1          • Principle(s) must have a satisfactory credit bureau report
           • Licensed in states where required.
3
 2     Required Attachments
           1. Copy of Certificate of Incorporation
           2. Copies of financial statements for three previous fiscal years and each completed
 3            fiscal quarter since last year.
           3. Listing of all secured debt, including amount owed, maximum credit line, security
              and name of creditor
           4. List of principles or partners owning 10% or more of company and of all officers of
              Dealer
1
           5. Copies of all state and local licenses held by Dealer
           6. Insurance Certificate for General Liability and Errors and Omissions Insurance
 2         7. Sales Tax Number and Tax Resale Certificate


 3      When you have completed this application please forward it with all
        required supportive documents to:
                         Mace Security International, Inc.
                         Authorized Dealer Program Coordinator
                         401 West Lincoln Ave,
                         Anaheim, CA 92805
                         877-484-9026
Authorized Dealer Program Application


    BUSINESS NAME:


    DBA IF APPLICABLE:                                                          DATE:


    BUSINESS ADDRESS:



    YEARS AT ABOVE ADDRESS                                                      YEARS IN BUSINESS

    BUSINESS TELEPHONE #:                                                       FAX #:

    PREVIOUS BUSINESS ADDRESSES (LAST FIVE YEARS):




    COMPANY PROFESSIONAL LICENSE #:


    TYPE OF PRODUCTS AND SYSTEMS SOLD:




    OWNERSHIP:              Corporation
                            Sole Proprietor                   Partnership

    If sole proprietor or partnership, is trade style registered?    Yes       No

    PRINCIPALS:
    Name                              Title                   Social Security Number     Residence Address



    REFERENCES:
    Product Suppliers
    Co. Name                          Address                 Representative             Phone #




    BANKS OF DEPOSIT:
    Bank Name                         Address                 Phone #                    Account #
Authorized Dealer Program Application


    Has any officer, stockholder, owner ever been listed on Federal Housing Administration’s precautionary (black) list?
                                                                                                 Yes         No
                        If yes, please explain:


    Is Dealer or any of its officers or stockholders (owners) presently under indictment or ever been convicted of a felony?
                                                                                                   Yes        No
                        If yes, please explain:


    Is Dealer or any of its officers or stockholders (owners) presently charged with or ever been convicted of violating any law relating
    to the business of our company which violation constitutes a misdemeanor?
                                                                                                    Yes         No
                        If yes, please explain:


    Is Dealer presently under investigation or has it been in the past five years by any federal, state or local government entity for pos-
    sible violation of a law in the conduct of its business?                                           Yes          No

                         If yes, please explain:


    Has Dealer’s License ever been revoked or suspended in the last five (5) years?                  Yes          No

                         If yes, please explain:


    Has Dealer or any of its officers, stockholders or employees ever been charged with an unfair or deceptive practice by the United
    States Federal Trade Commission of any other agency?                                          Yes        No

                         If yes, please explain:


    Is Dealer or any of its officers, stockholders or employees presently under investigation for unfair or deceptive practice by the
    United States Federal Trade Commission or any other agency?                                   Yes         No

                         If yes, please explain:


    The undersigned grants Mace Security International, Inc. or assignee’s the right to request and review undersigns credit and/or
    criminal background report.

    THIS STATEMENT EXECUTED THIS                             DAY OF                                  , 20

    EXECUTED BY:                                                                                     TITLE:



    Dealer’s Signature                                                                               Date


    Dealer’s Signature                                                                               Date
Authorized Dealer Program Application


                                                          Appendix A
                                                          Dealer Profile

    Company Name and Address




    Geographic areas covered:




    Profile of your target customer:




    What are vertical markets do you target?




    Products Currently Marketed:
                                Product                                    Manufacturer




    Identify your major competitors:




    In your typical sales scenario:

    Do you issue a formal quote/proposal?
    How many sale calls are required in a typical sale?
    Do your vendors make sales calls with you?
Authorized Dealer Program Application



                                 Customer References: Please Provide 3 Customer References

    Name:
    Address:
    City, State, Zip:
    Contact and Phone #

    Name
    Address
    City, State, Zip
    Contact and Phone #

    Name
    Address
    City, State, Zip
    Contact and Phone #

    Revenue and Customer Information:
    Number of Customers:
    Number of Installations:
    Estimated Revenue this year:
    % New Systems Sales versus Service:
    Average revenue growth rate over the past 3 years:

    Support Profile:
    Who installs your systems?
            Your own staff
            Third party contractor

    Do you currently offer maintenance programs and what % of your current customer base participates?




    During what hours is service generally available?

    What are the current technical certification requirements for the primary products that you sell today?




    How many hours of training do you offer to your customers and what type of training is it?
Authorized Dealer Program Application



                                                     Organizational Profile
    Organizational Profile
    Please list the number of employees by primary function:


     Primary Function                         Number of full time employees   Number of Part-time or Contract Employees

     Direct Sales

     Service/Support

     Administrative

     Executive

     Total Employees

								
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