Authorized Reseller Application

TO SIGNIFY THEIR ASSENT, each Party, intending this Agreement to be effective as of the Effective Date, has caused this Agreement to be executed by its duly authorized representative.

NOTE: BEFORE STARTING THIS APPLICATION, PLEASE DOWNLOAD AND REVIEW THE ATTACHED DOCUMENTS AS YOU WILL BE REQUIRED TO PROVIDE A SIGNATURE AT THE END OF THE APPLICATION INDICATING THAT YOU HAVE READ AND AGREE TO THE TERMS AND CONDITIONS OUTLINED THEREIN. NOTE: YOU WILL ONLY NEED TO PROVIDE A SIGNATURE FOR SCHEDULE B (INCLUDED IN THE AUTHORIZED RESELLER AGREEMENT FILE) AND THE INTERNET SALES ADDENDUM FOR AUTHORIZED RESELLERS IF YOU SELECT SELL ONLINE.

AFTER YOU'VE DOWNLOADED THE FORMS, YOU CAN FINISH COMPLETING THE ONLINE APPLICATION.

* Indicates a required field

Authorized Reseller Agreement

Internet Sales Addendum for Authorized Resellers

CUSTOMER INFORMATION

Company Name *

d/b/a (if applicable)

Web URL

Billing Name (if different than Company)

Billing Address *

City *

State/Province

Zip/Postal Code *

Country *

Shipping Address (if different than Billing Address; cannot be blank if Billing Address is a PO box address)

City

State/Province

Zip/Postal Code

Country

Company Email Address *

Phone Number *

Fax Number

Contact Name (for all mailings) *

Contact Phone *

Contact Email *

Do you have more than one store/branch location? *

Yes

No

Attach Complete Store Listing

Do you sell online? *

Yes

No

Do you have a walk-in
Service location? *

Yes

No

Do you have dedicated
Service personnel? *

Yes

No

Do you have a reception area
for Customers? *

Yes

No

Do you have a secure workshop area for repairs, storage of parts and
incoming units for repair? *

Yes

No

UNIFORM SALES & USE TAX

MULTIJURISDICTION

Each new customer is required to submit their sales tax exemption or resale certificate number. This exemption is exclusively for the Navico customer. The issuer and the recipient have the

responsibility of determining the proper use of this certificate under applicable laws in each state, as these may change from time to time.

Issued to Seller: Navico, 4500 S 129^th E Ave, Ste 200, Tulsa OK 74134-5885

Are you attaching your state issued Resale or Tax Exempt Certificate? *

Yes

No (complete the below fields)

Attach your Tax Certificate(s) here for all states
in which you are registered. *

I certify that the Company Name listed above is engaged as a registered (select one Type of Business below), and is registered with the below listed states and cities within which your firm would deliver purchases to us and that any such purchases are for wholesale, resale, ingredients or components of a new product or service to be resold, leased, or rented in the normal course of business. We are in the business of wholesaling, retailing, manufacturing, leasing (renting) the following:

Type of Business *

Description of Business: *

General description of tangible property of taxable services to be purchased from the seller: *

State/Province: Select the state for which you are registered.
If you see a number beside the selected state, click here
Uniform Sales & Use Tax Certificate
for an explanation specific to that state. *