E-Commerce Authorization Request

This E-Commerce Authorization Request Form is for companies interested in becoming an Authorized Bradford White Water Heaters E-commerce Seller (SELLING ORGANIZATION). An Authorization Request Form must be completed for EACH selling domain (URL) that is intended for use as an on-line storefront for selling Bradford White water heaters. Forms may take up to 30 days for review and communication of authorization outcome.

Parent Company Information (all information required):

Parent Company Name(Required)

Parent Organization URL(Required)

Address(Required)

Main Contact Number(Required)

Contact Person(s):

Name(Required)

Email(Required)

Phone(Required)

Name

Email

Phone

Selling Organization Information (if different than Parent Company):

Selling Organization Name

Selling Organization URL

Address

Main Contact Number

ACKNOWLEDGEMENT & SIGNATURE – Please read carefully, acknowledge and sign:

As a representative of the applying Parent & Selling Organizations, I have read and agree to the terms in the Bradford White Water Heaters E-Commerce Requirements for Authorized E-Commerce Sellers. I understand that failure of the Selling Organization or its representatives to comply with Bradford White Water Heaters’ Internet Minimum Advertised Price (IMAP) and E-Commerce Requirements for Authorized E-Commerce Sellers may result in the revocation of any e-commerce support to the “authorized e-commerce seller” from Bradford White.

Name(Required)

Date(Required)

Signature: