Registration

CUSTOMER TYPE

COMPANY INFO

Company Name:
Street Address:
Street Address 2:
Post Code:
City:
Country:
State/Province:

Federal Tax ID Number:
Sales Tax Exempt #:	(optional)
Sales Tax Exempt State:

INDIVIDUAL CONTACT INFO

First Name:
Last Name:
E-Mail:
Telephone Number:
Fax Number:

YOUR PASSWORD

Password:
Password Confirmation:

TERMS ACCOUNT Click to apply for credit

Owner/Officer:
Corporation:	YesNo
Federal ID#/SSN:
DistributorHospitalSurgery CenterPackager

Monthly Credit Limit Requested:

Accounts Payable Contact:
Phone:
Fax:
Email:

Buyer/Purchasing Contact:
Phone:
Fax:
Email:

Credit References: Provide Company Name, Contact with phone and fax and your account #. (Please do not include the following vendors as references since they do not provide information: Abbott Laboratories, Cardinal, McKesson, Medline and Becton Dickinson.)

Reference 1:
Reference 2:
Reference 3:

Authorization is herby given to make inquiry of all trade and financial sources which are deemed necessary to promptly evaluate this application.

Signed By:
Title:
Date:

TERMS AND CONDITIONS I agree to the following terms & conditions

Sterile Terms (Direct)
Payment Terms: Net 30
MCD sterile products can be purchased in box quantities
Minimum order: one box
Ground transportation charges will be prepaid by MCD on orders greater than $250.00 shipped within the contiguous United States.
The customer is responsible for a $15.00 shipping charge on orders less than $250.00 to one ship-to location.
Method of shipment shall be determined by MCD, and the delivery schedule negotiated at time of order.
Shipments expedited per customer request shall be a customer charge.

Sterile Terms (Distributors)
Payment Terms: 1% 20, net 30, unless contract specified
MCD sterile products can be purchased in box quantities
Minimum order: one box
Ground transportation charges will be prepaid by MCD on orders greater than $600.00 shipped within the contiguous United States to one Distributor ship-to location.
The Distributor is responsible for a a $25.00 shipping charge on purchase orders less than $600.00 to one ship-to location.
The Distributor is responsible for a $25.00 processing fee on drop shipments to end user locations. Distributor is expected to stock MCD Products.
Transportation cost for shipments expedited per Distributor request will be the Distributor’s responsibility.
Method of shipment shall be determined by MCD, and the delivery schedule negotiated at time of order.

Non-Sterile Terms (Pack Companies)
Payment Terms: 1% 20, net 30, unless contract specified
MCD non-sterile products are sold in case quantities
Minimum order: one case
Shipping charges will be paid by MCD on all purchase orders greater than $600 within the contiguous United States.
The customer is responsible for a a $25.00 shipping charge on purchase orders less than $600.00 to one ship-to location.
Method of shipment shall be determined by MCD, and the delivery schedule negotiated at the time of order.
Shipments expedited per customer requests shall be a customer charge.

International Terms (NS and Sterile Products)
Payment Terms: Cash in Advance unless contract specified
MCD non-sterile products are sold in case quantities; sterile products are sold in box quantities
Shipping charges will be paid by the customer.
Preferred method of shipment should be specified on the order.

Return Goods Policy
MCD warrants its products to be of good workmanship and in conformity with MCD specifications. Claims for defects or shortages must be made within 45 days after receipt of merchandise. Requests for return of standard product received within 45 days after receipt of merchandise is returnable for full credit. Authorized returns for standard product within a period of 46 to 120 days from shipment, will be assessed a 15% restocking charge with a $25.00 minimum. Authorized returns for standard product between 121 and 180 days will be assessed a 30% restocking fee with a $50.00 minimum. No credit will be given on products over 180 days from the shipment date. Merchandise may not be returned without a Returned Goods Authorization Number (RGA) or written approval by an MCD officer. Replacement of slow-moving standard MCD inventory with product of equal value is permissible, without penalty, within 120 days after receipt date subject to MCD approval. MCD will be responsible for shipping costs under the following conditions: (1) product does not meet specifications; (2) product is defective; or (3) established shipping requirements are not met by MCD. Shipping charges are the responsibility of the customer for returned product under the following conditions: (1) if the product is improperly ordered; (2) if acceptable product is returned; or (3) for the replacement of slow-moving standard stock. Only sealed, undamaged box quantities are returnable.

No representative of MCD is authorized to make any warranties, claims, promises or variations in the above terms without written approval by an MCD officer.

Medical Concepts Development, Inc. reserves the right to discontinue products, change specifications, designs, terms, and conditions of sale without prior notice.