Safe Zone Dealers

Primary Contact Name *

First Name

Last Name

Phone *

(###)

###

####

Secondary Contact Name *

First Name

Last Name

Phone *

(###)

###

####

Physical Shop Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Bill To Address (if different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Ship To Address (if different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you purchased from EVT previously? *

YES

NO

UNSURE

Have you sold the Safe Zone Mirror previously? *

YES

NO

I AGREE TO TERMS *

TERMS * MSRP/MAP = $40.00 * Enforced Internet Policy: Mirror cannot be sold on your company website for less than $40 shipped, IE $32 plus $8 minimum shipping. * Under no circumstances may any products purchased direct from EVT be sold on third party websites including but not limited to Amazon or eBay. * Minimum order = one * All orders placed by your shop/organization must be shipped to the address we have on file. * All orders must be placed using the email we have on file. Orders from other emails will be canceled. * Integrity required - No undercutting by internet retail. * Do not order tools/parts for your friends/family who work at your shop. Employee purchases are okay from an approved email. * Violation or abuse of the EVT/Dealer relationship will be cause for halting of sales to your shop/organization. * Violation of agreement can lead to consequences up to but not limited to legal action on behalf of Efficient Velo Tools LLC.

YES

NO