This application will be considered a legal and binding contract between A-I-R-Inc. and you, the Commercial purchaser, for the purpose of purchasing our product. Please print and complete the form below and fax to 217-498-9978. Your Account Number and Commercial Pricing will be returned promptly by fax or mail.
Name:_____________________________________
Title:____________________________________
Organization:_____________________________
Work Phone:_______________________________
Fax:______________________________________
E-mail:___________________________________
Website:__________________________________
State Tax ID:_____________________________
FEIN:_____________________________________
Business Name:____________________________
Street Address:___________________________
Address (cont.):__________________________
City:_____________________________________
State/Province:___________________________
Zip/Postal Code:__________________________
Country:__________________________________
Thank you for your account application at A-I-R-Inc.
A.I.R. Inc P O Box 1150 411 East Monroe Street Springfield, IL62705 United States ph: 217-698-8858 fax: 217-498-9978