563 322 6204 Mon - Fri 7:00AM - 5:00PM 737 Charlotte St. Davenport, IA 52803 US. HomeMechanical Products MECHANICAL PRODUCTS REPUBLIC IS THE PREMIER DISTRIBUTOR OF MECHANICAL PRODUCTS IN THE QUAD CITIES, EASTERN IOWA, WESTERN ILLINOIS, AND SOUTHWEST WISCONSIN Please refer to our residential lead product line card below to view our products. UNITARY EQUIPMENT DUCTLESS BOILERS & WATER HEATERS GEOTHERMAL CONTROLS PARTS & TOOLS DUCTWORK & SHEET METAL REFRIGERANT HEATERS HYDRONICS FLEX DUCT A/C RENTAL VENTILATION VENTS & FITTINGS ALL REPUBLIC MECHANICAL PRODUCT LINES: A-K 3M Amtrol Aeroflex ADP Barber Colman B & D Manufacturing Belimo Bell & Gossett Bosch C & S Manufacturing Chandler Chemours/DuPont Combraco Cooper Instruments Cozy Heaters Diversitech Dottie Duro Dyne DuroZone Embassy Enerco Erie EWC Fantech Field Fireye Fluke Frasier-Johnston Functional Devices Grasslin Great Lakes Copper Harris Hart & Cooley Hitachi VRF Hoffman Honeywell -Residential -Industrial Combustion -Controls (BBC) -Pneumatic -Generators -Cable ICM ICOR Intermatic Invensys Jason Industrial Inc. JB Industries JMF Johnson Controls Kele Klein Tools L-Z Lenox Little Giant Pumps Lochinvar Luxaire Malco Products MARS Maxitrol McDonnell & Miller Mitsubishi Modine Monti & Associates Munchkin Nu – Calgon Paragon Timers Packard Parker – Hannifin Ranco Controls Rectorseal Rehau Ritchie Engineering Robertshaw Rupp Schneider Schwank Sealed Unit Parts Selkirk Metalbestos Southwark Sporlan Valve Tecumseh Tekmar Controls TEMP-COOL Trion UEI Unico Uniline Virginia Watsco Inc. Weil McLain Weiss Westwood White-Rodgers WILO YORK Zebra Copyright © 2017 Republic. All rights reserved

563 322 6204 Mon - Fri 7:00AM - 5:00PM 737 Charlotte St. Davenport, IA 52803 US. HomeForms FORMS NEW CUSTOMERS (CREATE ACCOUNT) EXISTING CUSTOMERS Forms to create an account are posted below for your convenience. Please complete all applicable documents, scan, and send to Tim Black at blackt@republicco.com. Contact Tim with questions at 563 383 6029 (Fax: 563 888 4504) Minimum requirements to create account: Must complete, sign, and date all areas of the first and second pages of credit application Must complete and sign W9 If tax exempt, you must also complete Tax Exempt form. Additional forms for your reference if needed. Click the button or preview image to download pdf. CREDIT APPLICATION W9 FOR CUSTOMERS SALES TAX EXEMPTION FORM WARRANTY FORM JOB INFORMATION SHEET SALES TAX FORM FOR ILLINOIS CONTRACTORS TO PURCHASE FROM A TAX EXEMPT ORGANIZATION TERMS OF SALE Copyright © 2017 Republic. All rights reserved