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Business Hours:
Monday through Friday
from 8:00 AM through 5:00 PM ET.
 
Customer Service:
Tel:  800-780-5051
Fax: 866-741-5484
E-mail: Please complete contact form
 
Mailing Address:
Replacement Hardware Mfg., Inc.
500 W 84 Street
Hialeah, FL 33014
Miami Numbers:
Tel:  305-558-5051
Fax: 305-557-5239
WELCOME TO REPLACEMENT HARDWARE MFG.,Inc.

Take advantage of becoming a set up customer: you will not have to enter all your information every time you place an order, Special Pricing, Credit Line if approved.

To set up an account with us, please complete the form below, after receiving your application a customer service representative will contact you once your account is set up.

Company Information
 
Company Name Date Established (MM/YYYY)  
 
Corporation

State

   
Proprietorship        
Partnership        
Other

Explain

 
Bill To Address  
 
City State Zip  
 
Ship To  Address   Check Here if Same as "Bill To" Address  
 
City     State Zip  
 
County        
     
Ship Via
UPS (preferred method)  
FEDEX    
OTHER  
 
Contact Information
 
Your Name Title  
 
E-Mail Telephone  
 
Purchasing Contact Not Applicable  
   
E-Mail Telephone  
 
Accounting Contact Not Applicable  
   
E-Mail Telephone  
 
Describe your business
 
Residential Commercial
Mobile Home / RV Distributor
Dealer Repair
Other
Purchasing Habits
 
Requires P.O.

Tax Exempt

No Yes
Estimated Annual Purchases Certificate No.
  We must have a signed Tax Certificate sent by mail
Accept Backorders  
Accept Partial Shipments  
Payment Method
Credit Card You will be asked to provide your Credit card information with your first order

COD

Please complete all this section for COD

By Checking this box, I attest financial responsibility and ability and willingness to pay Replacement Hardware Manufacturing invoices upon receipt.
Driver's License
 
Two Personal References
Name Telephone
Open Account  

Amount of credit Requested

         
Owners, Partners or Corporate Officers (only for Open Accounts)
 
1 Name Title
 
  Address Phone
 
2 Name Title
 
  Address Phone
 
3 Name Title
 
  Address Phone
 
Bank Reference (only for Open Accounts)
 
1 Bank Name Account
 
  Contact Phone
 
  Branch Address  
 
Trade References (only for Open Accounts)
 
1 Name Phone
 
  Contact E-Mail
 
  Address  
 
2 Name Phone
 
  Contact E-Mail
 
  Address  
 
3 Name Phone
 
  Contact E-Mail
 
  Address  
 
Your Signature
 
By Checking this box I certify that the information given is correct. I also authorize Replacement Hardware Manufacturing  to contact my company references.
     
  My Name Title
 
     
All  this information will be held in strictest confidence.