Please complete this Account Registration form. Upon completion, you will receive a welcome letter via E-Mail within 3 business days if approved.

Contact Information

Payment Information

Payment Information

TERMS & CONDITIONS
TERMS/PAYMENT - Open account terms will be granted to qualified customers upon credit approval. Payment terms for
open accounts are NET 30 Days from the date of purchase. Past due invoices are subject to a service charge of 2.5% per
month. For delinquent accounts, Western Medical Inc. reserves the right to decline or cancel shipments on future orders
until all delinquent invoices are paid in full. A $25 service charge will be assessed on all returned checks. In the event
where the full invoice amount is not paid within terms (net 30), Western Medical reserves the right to apply the invoice
amount to the required credit card provided (see account authorization form) after 35 days (5 day grace period). Western
will charge a fee equal to 2.5% of the invoice amount when the card is charged at the end of the 35 days.


SHIPPING & FREIGHT - Orders are primarily shipped F.O.B. Destination using FEDEX or USPS. Orders are typically
processed and shipped the same day when received by 2:00 pm Pacific Time. If an item is backordered, it will be shipped
upon our receipt. Western Medical Inc. shall not be liable for any losses which result from manufacturer’s delay or delays
in transportation for whatever reason that are caused and beyond the control of Western Medical Inc.

Business and Ownership Information

Business and Ownership Information

Trade References Currently Doing Business With

Trade References Currently Doing Business With

MAP Pricing

Map Pricing

MAP Pricing
MAP pricing for all products can be found on current price list (below). All advertised prices must be at or above MAP for
Company Products. Resellers are required to list prices in advertising. All prices listed in an advertisement must be at or
above MAP. Resellers are also responsible for ensuring that Company Products are at or above MAP on internet search
engines. Resellers are free to set the actual resale price of any product as long as it is at or above MAP price given the
most recent publication of the price list. Company’s MAP policy for all Products and Services apply to advertising
placements, including but not limited to: print ads, broadcast (radio and TV), direct mail, faxes, internet placements on
resellers own website, and any flyers, posters or coupons. Resellers are not permitted to place products on third party
sites such as Amazon, Wall Mart.com, Ebay, etc unless provided express written consent by Company. From time to time,
Company may permit resellers to advertise these products at prices lower than the MAP price. In such events, Company
reserves the right to modify or suspend the MAP price with respect to the affected products for a specified period of time
(ie. Black Friday, Cyber Monday, etc,) by providing advance notice to all resellers of such.

MAP for Resellers of EXP PRO, CPAP Comfort Cover. The products subject to
this agreement are as follows:

CPAP Comfort Cover
MAP = $19.99 MSRP = $24.99

EXP48PRO Battery Bank - MAP/MSRP = $379.00
EXP96PRO Battery Bank - MAP/MSRP = $499.00 / $579.00

Returns and Warranties

Returns and Warranties

RETURN POLICY
All product returns must have a Return Authorization Number and will be valid for 30 days.

Non-returnable Items
Items, including their packaging, showing visible signs of wear are non-returnable and non-refundable with the exception
of defective items under warranty. No credit will be issued for obsolete or otherwise non-saleable merchandise, including
outdated packaging and items worn by the customer.

Non-warranty Returns
Non-warranty returns in original, unused condition will be accepted within 3 months from the date of purchase and will
be subject to a 15% restocking fee. The restocking fee may be higher for special-order items.

Warranty Returns
Western Medical Inc. will not accept items for return that have been worn by the customer, with the exception of
defective items under manufacturer warranty. Western Medical Inc. will always defer to the manufacturer’s warranty
policy.

The following information is required to obtain a return authorization from Western Medical Inc. Customer Service –
 Full description of merchandise including item number
 Complete reason for return
 Sales Order, Invoice, or Purchase Order Number
Additional information may be needed if required by manufacturer.

ANY WARRANTIES ON THE GOODS OR EQUIPMENT SOLD HEREBY ARE LIMITED TO THOSE MADE BY THE MANUFACTURER. WESTERN MEDICAL INC HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES, EITHER EXPRESS OR IMPLIED, INCLUDING ALL IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND REPLACE OR GIVE CREDIT FOR ANY DEFECTIVE GOODS OR EQUIPMENT. IN NO EVENT SHALL WESTERN MEDICAL INC BE LIABLE TO CUSTOMER FOR SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES OR ANY OTHER EXPENSES INCURRED BY CUSTOMER AS A RESULT OF ANY DEFECTIVE GOODS OR EQUIPMENT.

JURISDICTION AND VENUE - These terms shall be construed under and governed by the laws of the state of Washington, Clark County.

Signature

E-Signature Confirmation

The listed information is herewith submitted for the purpose of opening an account and I do certify that the information contained in this form is accurate and complete.  

By signing, you are agreeing to terms & conditions, return policy, MAP pricing and warranties contained in this form.

I, the applicant for this account set up form, warrant the truthfulness of the information provided in this application.