Work With Us

If you have equipment, we have solutions. Find your lubrication and application equipment needs here. Fill out the form below to get started!

Payment Terms(Required)

Company Name (Headquarters) As Listed On W9(Required)

How did you find us?(Required)

Provide How You Found Us Here

Business Type(Required)

Federal Tax ID (If W9 is not provided)(Required)

D&B Duns #

DBA (If Applicable)

Date Of Establishment(Required)

State & Country Of Legal Establishment(Required)

Select One(Required)

If Division/Subsidiary/Affiliate, Name Of Company

Location(Required)

City State / Province / Region ZIP / Postal Code Country

Bill To Information

Bill To Name(Required)

Bill To Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Ship To Information

Ship To Name(Required)

Ship To Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Information

Purchasing Name(Required)

Purchasing Phone(Required)

Purchasing Email(Required)

Accounts Payable Name(Required)

Accounts Payable Phone(Required)

Accounts Payable Email(Required)

Email Address To Receive Your Invoices(Required)

Est. Monthly Purchases ($USD)(Required)

Please note, a 3% convenience fee will apply.

Tax Status

Tax Exempt(Required)

Yes

For Export

Tax Exemption Form(Required)

Max. file size: 512 MB.

ALL SALES ARE TAXABLE UNLESS A COPY OF YOUR SHIPPING LOCATION STATE TAX EXEMPTION CERTIFICATE ACCOMPANIES THIS APPLICATION

Shipping Details

Freight Method(Required)

If 3rd Party, Provide Information

Company Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Small Pkg. Carrier

Small Pkg. Carrier Account Number

LTL Carrier

LTL Carrier Account Number

Special Shipping Instructions

LubeCon USA LLC's Standard Terms Are 30 Days. Please Check To Confirm That You Have Read And Accept These Terms

Accepted

Other (requires business approval)

We Hereby Authorize LubeCon USA LLC To Request Credit Information From The Below Listed Banks And Companies. Terms Acceptance And Signature Required Below.

Yes

If Other Was Selected, Please Provide Preferred Payment Terms

References

Bank Reference Name(Required)

Branch(Required)

Bank Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Trade Reference 1(Required)

Trade Reference 1 Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

W9 Form or Equivalent(Required)

Max. file size: 512 MB.

Your Information

Name Of Person Completing Form (Signature Authorization)(Required)

First Last

Email(Required)

Phone(Required)

Additional Comments

Work With Us

If you have equipment, we have solutions. Find your lubrication and application equipment needs here. Fill out the form below to get started!

Bill To Information

Ship To Information

Contact Information

Tax Status

Shipping Details

References

Your Information

If you have machines. We have solutions. Find your custom conveyor solutions here.