Distributor Coop | Vortexx Pressure Washers

Distributor*

Submission Date

Your Email*

Type*

If the distributor paid 100% of the cost, please select distributor. If the dealer paid 50% of the cost, please select dealer advertising.

Dealer Advertising
Distributor Advertising

Dealer Advertising

Please only fill out this section if a dealer paid a % of the claim

Dealer Name

Dealer Coop Share

example: If dealer paid 50% of the total, Vortexx will credit 25% of the total to the distributors account (Distributor pays 25% of total). Please enter amount in dollars (not %)

Claim Information

Invoice Date*

Co-Op Category*

Total Co-Op Amount*

Please list total cost on invoice devoted to Vortexx

Distributor & Vortexx Share (each)*

For non-dealer claims only (distributor & vortexx each pay 50%). For dealer claims, dealer pays 50%, dist 25%, vortexx 25%

Description

Supporting Documentation

You may take a picture or scan the documentation to attach. If you are unable to scan, please mail to Vortex Industries Inc. Attn: Coop, 739 S Mill Street, Plymouth, MI 48170 or fax to 1-800-680-7735

Drop files here or

Max. file size: 10 MB.

Vortexx Distributor Coop Claim Form

Dealer Advertising

Claim Information