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Sample Request Form
4615 State Street, Montclair, CA 91763 | t: (909) 627-5333 | f: (909) 627-2887 | e: sales@archipelagolighting.com
REQUEST FOR SAMPLES Archipelago Lighting is proud to manufacture premier LED lighting products. It is important for our distributors and sales reps to obtain samples for the customer base they service to interact with and to secure specification opportunities. In order to provide an efficient and accurate inventory of our samples, we require all sample requests to adhere to our sample policy. * Distributor / Rep Agency Name * Contact Name * Email Contact Number * Product Number and Quantities * Shipper Account Number * Delivery Address
Address line City * Please describe the opportunity, including the application(s), quantities, and other pertinent information * Billing Information (No Cost is determined by 1R &RVW Sales Manager) If Credit Upon Return, Specify Desired Return Due Date If Purchase or Credit, Billing Address City
1 State
Purchase
Postal
Credit Upon Return
Address line State Postal
Our Sample Policy allows product samples to be easily purchased and returned for full credit, when returned in new condition and in the original packaging: No Cost – Returning Samples • • • • •
Invoiced samples to be returned within 60 days Contact Customer Service for RA# (909-6275333) Must be returned in New Condition and in the Original Packaging Returns must be freight prepaid
Cost – Purchasing Samples
Credit Upon Return
Rep Agency – • • Sample Kit will be provided on a loaner basis • All Sample Kit must be returned freight • prepaid in the event of resignation or termination Customers – • Samples paid in advance or NET60 – per Sales • Department discretion • Freight charged against Customer’s freight account
Full credit will be issued for samples returned in New Condition and in the Original Packaging Please note that any return freight damage is the responsibility of your customer and their carrier
By signing here, I agree to ARCHIPELAGO LIGHTING’s Sample Policy: Signature: _____________________________ Date: ______________________________
4615 State Street, Montclair, CA 91763 | t: (909) 627-5333 | f: (909) 627-2887 | e: sales@archipelagolighting.com