720 S Powerline Suite D

Deerfield Beach, Florida 33442

Toll Free: 877-724-3266
Office: (954) 596-2355
Fax: (954) 596-0070
Email:
accounting@reaganwireless.c
om www.reaganwireless.com

New Customer Application Form

COMPANY INFORMATION
JUNGLE RIDES
Company Name________________________________________________________________________
CARRERA 44 # 72 63
Address ______________________________________________________________________________
COLOMBIA BARRANQUILLA
City __________________________________ ATLANTICO
State ______________ 080002
Zip Code ____________ ___

Entity Type: Corp ____ S-Corp____ LLC ____ Sole Proprietorship ___ Other ___________________
✔ Retail ____ MVNO ____ Distributor ____ Other _____________
Nature of Business: Wholesale ____

Years in Operation: 4 YEAR

_________________________

Contact Name _LINA MARCELA VILLA ACEVEDO

______________________________________________________________________
3017142220
Phone Number ________________ _____ Cellular 3017142220
_________________
PIKABUKISS@GMAIL.COM
E-mail _______________________________________________________________________________

Reagan Salesperson ____________________________________________________________________

CARRIER INFORMATION (if applicable)

Name of Carrier whose product line you carry: _______________________________________________

Dealer Account Name __________________________ Account Number: _______________________

How many Years ______________________________

PRESIDENT / OWNER INFORMATION

LINA MARCELA VILLA
Name________________________________________________________________________________
CARRERA 44 72 63
Address ______________________________________________________________________________
BARRANQUILLA
City __________________________________ ATLANTICO
State __________________ 080002
Zip Code ________________
COLOMBIA
Country _____________________________________________________________________________

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BANKING INFORMATION

Name of Bank _________________________________________________________________________

Address ______________________________________________________________________________

City _____________________________________ State ______________ Zip Code _________________

Country__________________________________ How Many Years ______________________________

Contact__________________________________ Phone Number________________________________

Account(s) # _____________________________

______________________________

TAX INFORMATION

D & B (DUNS) #: __________________________________ Federal Tax Id: _____________________

Tax Exempt #: __________________________________ * Must attach copy of sales tax registration certificate and
Business License.

TRADE REFERENCES
Name TECNO CLIMA
____________________________________ Name GREISY DALENA MEDINA
____________________________________
____________________________ Phone Number 3008543254
Phone Number 3042417323 ____________________________
CAMILO ROCHA
Contact __________________________________ Contact __________________________________
E-mail of Contact __________________________ E-mail of Contact __________________________
Terms/Credit limit __________________________ Terms/Credit limit __________________________

TELEVARIEDADES ACUÑA
Name ____________________________________ Name ____________________________________
Phone Number 3103963332
____________________________ Phone Number ____________________________
SONIA PERTUZ
Contact __________________________________ Contact __________________________________
E-mail of Contact __________________________ E-mail of Contact __________________________
Terms/Credit limit __________________________ Terms/Credit limit __________________________

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TERMS AND CONDITIONS

CREDIT. Upon approval of this application, Reagan Wireless Corporation (“REAGAN”), in its sole discretion,
will assign Applicant a credit line and/or other terms, and shall have the right to increase, decrease, or
terminate Applicant’s credit privileges under this Application at any time without prior notice to Applicant,
except as otherwise provided by law.

PRODUCT. A “Product” includes any and all goods and services, including but not limited to, CDMA
cellular/smart phones, GSM cellular/smart phones, Apple phones, laptops, tablets, memory cards, Bluetooth,
batteries, battery doors, hotspots, parts/LCD’s, car chargers, home chargers, data cables, headsets, cases,
accessories and any and all merchandise sold by REAGAN.

INVOICES. Payment of the purchase price for goods and/or services acquired from REAGAN shall be made
pursuant to the payment terms set forth on each invoice, and Applicant agrees to pay all charges according
to the payment terms established in said invoice. The entire outstanding balance due on all invoices shall
become due to REAGAN in full immediately upon default in the payment of any invoice.

INTEREST. Applicant agrees to pay simple interest in the amount of 1.5% per month on any payment past
due, pursuant to the terms set forth on each invoice until collected.

ACCURACY OF INFORMATION. Applicant hereby certifies that the information furnished under this
application and on any financial statements furnished in connection herewith, is true and correct and thi s
information is being furnished to REAGAN for the purpose of inducing REAGAN to extend credit to Applicant,
and Applicant understands that REAGAN will rely upon such information as correct

AUTHORIZATION TO RELEASE INFORMATION. Applicant authorizes REAGAN to perform any credit

checks, which includes, but is not limited to, contacting credit reporting agencies, bank references and trade
references listed in this application, to ascertain the Applicant’s credit history and current credit status.

WAIVER. The failure of a party to insist, in any one or more instances, on performance of these Terms &
Conditions or under any invoice, or to exercise any right hereunder or under the invoice, is not a waiver of the
future performances of any terms, covenant, condition or the future exercise of such right.

JURISDICTION. Any dispute arising from this contractual relationship, including but not limited to the “Terms
and Conditions” in this New Customer Application Form, sales orders, invoices and the Terms of Use under
the REAGAN website shall be governed by Florida law, and shall be decided solely and exclusively by State
or Federal courts located in Broward County, Florida.

EXPENSES OF ENFORCEMENT. The prevailing party shall be entitled to recover all costs and expenses
including, without limitation, reasonable attorney’s fees and the fees of any collection agency and court costs,
incurred by the prevailing party in exercising any of its rights or remedies hereunder or under an invoice, or
enforcing any of the Terms & Conditions or provisions hereunder or under an invoice.

REPRESENTATIONS AND WARRANTIES. Each party represents and warrants to the other that the
execution and delivery of these Terms & Conditions and the performance of such Party’s obligations hereunder
have been duly authorized and that the Terms & Conditions are valid and legally binding on such Party and
enforceable in accordance with its terms. REAGAN warrants that all products furnished under these Terms &
Conditions will conform to the description of products included in the sales order and invoice. REAGAN
warrants that the products provided to Applicant will not violate or conflict with any U.S. laws, including
intellectual property rights of any third parties, and will not breach any contract or obligation to which REAGAN
is a party. REAGAN is a reseller of telecommunication equipment. No manufacturer warranty is available.
Products sold are subject to the warranties agreed upon pursuant to the sales order and invoice. There are
no warranties which extend beyond the description on the face of this Agreement or in the sales order and
invoice. ANY PRODUCT THAT HAS BEEN ABUSED, MISUSED, ALTERED, TAMPERED, UNLOCKED
AND/OR HAD ITS SOFTWARE ALTERTED WILL VOID ANY AND ALL WARRANTIES, INCLUDING BUT
NOT LIMITED TO ANY WARRANTIES IN THIS AGREEMENT, SALES ORDERS AND INVOICES.

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 MAXIMUM LIABILITY. IN NO EVENT SHALL REAGAN’S AGGREGATE LIABILITY ARISING OUT OF OR
RELATED TO THIS AGREEMENT, WHETHER ARISING OUT OF OR RELATED TO BREACH OF
CONTRACT, TORT (INCLUDING NEGLIGENCE), OR OTHERWISE, EXCEED THE REPLACEMENT
VALUE OF THE PRODUCT OR PRODUCTS PURCHASED BY THE APPLICANT IN THE ONE (1) YEAR
PERIOD PRECEEDING THE EVENT GIVING RISE TO THE CLAIM.

RETURNS. This Section applies to products received that are defective/damaged/missing parts. THIS
SECTION DOES NOT APPLY TO ANY PRODUCT THAT HAS BEEN ABUSED, MISUSED, ALTERED,
TAMPERED, UNLOCKED AND/OR HAD ITS SOFTWARE ALTERED AND THEREFORE NO RETURNS
WILL BE ACCPTED ON ANY AND ALL PRODUCTS THAT HAVE BEEN ABUSED, MISUSED, ALTERED,
TAMPERED, UNLOCKED AND/ OR HAD ITS SOFTWARE ALTERED. (i)No returns will be accepted without
prior authorization of REAGAN, (which shall not be unreasonably withheld; (ii) Returns for defective items (i.e.
items that have not been abused, misused, altered, tampered, unlocked and/or had its software altered) will
be accepted; (iii) Return authorization must be obtained within 30 days of receipt of the product, and the
product must be received within 15 days of the authorization issuance; (iv) Original shipping & handling are
not refundable; (v) Applicant is responsible for shipping and proof of delivery on all returns (retain all tracking
information from the shipper until credited and REAGAN requires that return shipments be properly packed
and fully insured); (vi) Returns are subject to a restocking fee of 15%, which will not apply to returns of defective
or incompatible items; and (vii) All non-product related fees (such as installation charges or special delivery
instructions) are not refundable; and (viii) Unauthorized returns will not be accepted. All returns must contain
all kitted accessories. Any missing items will be subject to a replacement charge

…………

GENERAL
(a) No modification of these Terms & Conditions shall be binding unless in writing signed by an authorized
representative of both parties.
(b) If any provision of these Terms & Conditions is unenforceable, such unenforceability shall not affect the
remainder of Terms & Conditions.
(c) This Terms & Conditions shall be binding on and shall inure to the benefit of the parties hereto and their
respective successors and assigns.
(d) The rights and remedies granted herein are non-exclusive to those otherwise available under law of equity.
(e) The terms and conditions of this contract and any sales and payments made pursuant hereto are performable
in Broward County, Florida.

Applicant: By Authorized Agent/Officer:

LINA MARCELA VILLA ACEVEDO

Firm Name: ________________________________ Signature: __________________________Date ____________
20072018

Personal Guaranty must be signed for all accounts other than “pre-paid wires”. If the Applicant has confidence in his
her or its ability to pay, then signing the below noted Personal Guaranty should not be an issue. Also be advised that
REAGAN has a “no tolerance” policy regarding late payment or bad checks.

If the following Personal Guaranty is not signed by a Guarantor no examination and inspection will be given by REAGAN
to the Applicant and this New Customer Application Form is NULL & VOID.

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 Personal Guaranty

The undersigned, _____________________________ (“Guarantor”) of ____________________________, having a

(Names of Individual and spouse) (Company Name)

Financial interest in Applicant, and benefiting from the transactions contemplated by this Agreement, hereby personally
guarantees the payment by Applicant to REAGAN of all amounts due and owing now, and from time to time hereafter.
Guarantor expressly waives notice from REAGAN of its acceptance and reliance on this personal guaranty, notice of
sales made to Applicant, and notice of default by Applicant. The obligations of Guarantor hereunder shall not be
affected, excused, modified or impaired upon the happening, from time to time of any event. No set-off, counterclaim
or reduction of any obligation, or any defense of any kind of nature which the Guarantor has or may have against
Applicant or REAGAN shall be available hereunder to the Guarantor against REAGAN in the event of a default by
Applicant on its obligation to REAGAN, REAGAN may proceed directly to enforce its rights hereunder and shall have
the right to proceed first against Guarantor without proceeding with, or exhausting, any other remedies it may have.
Guarantor agrees to pay all costs, expenses, and fees, including reasonable attorney’s fees, which may be incurred by
REAGAN in enforcing this personal guaranty or protecting its rights following any default on the part of Guarantor.
Guarantor agrees that an interest charge of one and a half percent (1.5%) per month, or the highest rate permitted by
law, whichever is less, shall be assessed on any amount due and owing to REAGAN by Guarantor under this personal
guaranty until collected. This Personal Guaranty shall be binding upon Guarantor, the Guarantor’s heirs, successors,
assignees, representatives and survivors, and shall inure to the benefit of REAGAN its successors and assigns. This
personal guaranty shall be governed by and interpreted with the laws and decisions of the State of Florida, without
respect to its conflicts of laws provisions, as is performable in Broward County, Florida. Any dispute arising out of this
personal guaranty will be resolved in Broward County, Florida. The obligations of multiple persons acting as Guarantor
shall be joint and several.

Print Name: _______________________________ Signature: _____________ Driver License # ________________

Title _____________________________________

Address _________________________________________________________________ Date ________________

Environmental, Health and Safety Policy

As a buyer, seller, and refurbisher of mobile phones, tablets, and other small electronics Reagan Wireless is
dedicated to the protection of non-renewable resources. Reagan Wireless recognizes and accepts its responsibility
to provide a safe and healthy working environment for all its employees, contractors and visitors who use its
premises.

Our Environmental Health & Safety Management System (EHSMS) governs the processing of this equipment as
well as the handling & processing of residual materials.

It is our intention to:

Maintain an environmental, health & safety program that is consistent with ISO 14001, OHSAS 18001 and
the R2 standard as well as reviewing the objectives and targets.

Comply with all federal, state, and local laws including those covering focus materials and other requirements
set by our management.

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 Comply with all regulations for countries of import for R2 focus materials under our control.

Commitment to prevention of injury and ill health and continual improvement in OH&S Management and
OH&S Performance

Focus on a management strategy that is based on a hierarchy of reuse and recover and as a last resort,
energy recovery.

Provide a safe workplace free of injury for our employees, contractors, temporary employees and visitors.

Ensure safe practices for the handling, storage and transport of focus materials

Commitment to continual improvement for the environment and prevention pollution

Our Take Back Policy

As a R2:2013 and ISO 14001:2004 recycler, Reagan Wireless takes seriously the impact of focus materials on
the environment. The equipment we sell is meant for reuse and should both meet the requirements of our
customers and have its’ key functions working. It is therefore our policy to take back all nonworking products
containing focus materials for recycling.

Reagan Wireless recognizes, as do many of our customers, the importance of recycling electronic equipment
at the end of its useful life. As an R2 certified we have a number of responsibilities, including the financing of
collection and recycling of non-working equipment, meeting labeling requirements, and providing information
to end users.

Reagan Wireless has a practical return policy that allows the buyer to return the product within 30 business
days or sales agreement terms, if key functions are not working. The shipping cost to return the items will be
covered by Reagan Wireless.

After 30 days of original purchase (outside of the practical return policy), all Reagan’s Customers can take
advantage of the recycling program. By navigating to reaganwireless.com/recycle, there you can email us at e -
waste@reaganwireless.com. Once we receive your submission, we will send you a shipping label.

Environmental Questionnaire

Company Name: Sales Person:

Date:

Yes No
1 Is your company ISO 14001 certified?

3 Does your company hold any other environmental or quality Yes No

certifications? If yes, please
list: ________________________________________________

Yes No
4 Do you buy products from Reagan Wireless that require repair? (If
you only purchase working/tested product from us skip questions 5
& 7)

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5 Does your company refurbish products? Yes No

6 Does your company purchase phones/equipment in an as is Yes No

condition?

7 Are all of the products sold by company sold with their key functions Yes No
working?

8 Yes No
Does your company export product to non-OECD countries?

9 Have you read and accepted the terms of Reagan Wireless’ take Yes No
back policy? (see above)

Name/Title Signature Date

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