Billtrust Login
Website Login
Plumbing, Electrical & HVAC Distributor
Main Menu
Products
By Manufacturer
Plumbing
Electrical
HVAC
Tools
Services
Commercial Services
About Us
Careers
News
Apply For Credit
Find A Branch
Cash Account Application
General Information
Business Name
Email
Mailing Address
City
County
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip Code
Street Address
City
County
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip Code
Phone
Fax
Home Office
Business Type
Sole Proprietor
Corporation
Partner
LLC
Government
Other
COMPANY REPRESENTATIVE OR PARTNERS
Name
Title
Phone
Name
Title
Phone
PURCHASING INSTRUCTIONS
Branch Number
Pricing Level
EPA #
EPA Level
EPA Name
Please submit your EPA certificate.
Add File
Are you tax exempt?
Yes
No
Please submit a tax exempt certificate.
Add File
Additional tax exempt certification.
Add File
Service Information
PO Required?
Yes
No
Allow Backorders?
Yes
No
Email Invoices?
Yes
No
Fax Invoices?
Yes
No
Please review your application and complete all required fields in order to submit this application.
Submit Application
SALES INFORMATION
(TO BE COMPLETED BY A LOCKE SUPPLY CO. ASSOCIATE ONLY)
Associate
Date
Branch #
Sales Rep Name
Sales Rep #
© 2021 - Locke Supply Co. All Rights Reserved
Terms Of Use
|
Privacy Policy
Feedback