Distributor Data Form

Change Type*
You must make a selection here before proceeding to the rest of the form.
- New Distributor
- Changes to an Existing Distributor
- New OEM/End User
- Changes to an Existing OEM/End User
- Cancel Distributor/OEM/End User
BASIC INFORMATION
Company Name*
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Bill-To*
- same as Mailing Address
- different from Mailing Address
Bill-To Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
DISTRIBUTOR CONTACTS
Manager / Owner
First Last
Email
Accounts Receivable
First Last
Email
Phone
Fax
Website
Payment Terms
Company Type*
- Pump Distributor
- Cataloger
- OEM
- End User
Region*
- Northeast USA
- South USA
- Midwest USA
- South Central USA
- West USA
- Northwest USA
- Canada / Mexico
- Latin America
- Europe/ Africa/ Middle East
- South Asia (India)
- APAC
- Northern / Eastern Europe
PERMISSIONS
Distributor has permission to sell:*
Select which product lines the customer can sell.
- Drum Pumps
- Plastic Centrifugals (DB/SP/GP/KC)
- AP Series
- UC Series
- FTI Air
- Pump-Fit
OEM/End User has permission to buy:*
Select which product lines the customer can purchase.
- Drum Pumps
- Plastic Centrifugals (DB/SP/GP/KC)
- AP Series
- UC Series
- FTI Air
- Pump-Fit
Website Permission
Select which website the company name and contact information should be listed on.
- www.finishthompson.com
- www.ftiair.com
- Do not list on websites
Price Schedule*
- List (U.S. & Canada)
- List (International)
- Net
- Net Euro
- Other (provide details in Special Pricing/Discounts section)
DISCOUNTS
Tier A
Plastic centrifugal pumps and drum pumps: 50% off Ultrachem UC Series ANSI pumps and parts: 35% off Spare parts totaling List Price Under $250.00: 20% off Spare parts totaling List Price Over $250.00: 40% off HVDP pumps/motors/BT motors/Drum Access: 25% off 316SS Baseplates, FRP, VFD's: Same as pump discount Power monitors: 20% off
Tier B
Plastic centrifugal pumps and drum pumps: 40% off Ultrachem UC Series ANSI pumps and parts: 35% off Spare parts totaling List Price Under $250.00: 20% off Spare parts totaling List Price Over $250.00: 30% off HVDP pumps/motors/BT motors/Drum Access: 25% off 316SS Baseplates, FRP, VFD's: Same as pump discount Power monitors: 20% off
Tier C
Plastic centrifugal pumps and drum pumps: 35% off Ultrachem UC Series ANSI pumps and parts: 35% off Spare parts totaling List Price Under $250.00: 20% off Spare parts totaling List Price Over $250.00: 30% off HVDP pumps/motors/BT motors/Drum Access: 25% off 316SS Baseplates, FRP, VFD's: Same as pump discount Power monitors: 20% off
Asian Discount
Plastic/SS centrifugal pumps and drum pumps: 60% off Spare parts (plastic/SS centrifugal, drum pump): 50% off HVDP pumps/motors/BT motors/Drum Access: 25% off Ultrachem UC Series ANSI pumps and parts: 35% off 316SS Baseplates, FRP, VFD's: Same as pump discount AC Series pumps with IEC metric frames are Net Price Power monitors: 20% off
FTI Air % Discount
Special Pricing/Discounts/Shipping Terms
List any non-standard pricing or discounts in this space.
Miscellaneous
Submitted By:*

Distributor Data Form

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