Warranty Service Center Sign Up

Please provide the details requested below to register as an Amalfi Series by Garden Leisure Warranty Service Center.

Question Title

* Company Details

Corporate Name (as registered with IRS or Canadian govn't agency)

dba (if applicable)

Fed Tax / GST ID

State Resale / PST #

Website

Question Title

* Primary Company Contact

Primary Contact Name *

Primary Contact Title *

Email Address *

Primary Business Phone Number

Question Title

* Signing Authority (if different than above)

Name

Title

Email Address

Phone Number

Question Title

* Billing Contact (if different than Primary Contact)

Billing Contact Name

Billing Email Address

Billing Phone Number

Question Title

* Billing Information

Street Address

City/Town

State/Province

ZIP/Postal Code

Country

Question Title

* Shipping Information (if different than Billing)

Primary Shipping Contact

Company Name

Street Address

City/Town

State/Province

ZIP/Postal Code

Country

Primary Contact Email Address

Primary Company Phone Number

Question Title

* Upload Certificate of Insurance

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* Upload Retail Certificate

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File