Representation

If you are looking for representation in the states we cover, please fill out the form below and click the SUBMIT button. Your information will go directly to Joe Hertig.

Please provide the following contact information:

Company Name
Your Name
Your Title
Address
Address Cont.
City
State
Zip Code
Phone
FAX
E-mail
Web Site

Manufacturing Information:

Types of products you manufacture?
How many years have you been in business?	Less than 1 year 1-2 years 3-5 years 5-10 years More than 10 years
Average Ship Time?
Commission Rate?	%
Commission on Direct orders?
States needed for representation?		Hold down the CTRL key to select multiple states
Do you have catalogs you can send to us?
Do you have samples you can send to us?
Additional Comments

Minnesota
Wisconsin
Iowa
North Dakota
South Dakota