APPLICATION FOR DISTRIBUTION AGREEMENT

The following information is requested to assist and guide our Licensing Department to fairly judge an applicant's ability and resources to develop a Double Cola bottling plant/distributorship and achieve maximum sales of Double Cola products throughout the requested territory.
All information will be held in the strictest confidence.
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 Sole Proprietorship Partnership Corporation

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  Owner/Officer Name Title Age % Ownership
1.
2.
3.
4.
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  Name Title Age Years Experience
1.
2.
3.
4.

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  Location Branch Manager’s Name
1.
2.
3.


  Name Address Contact Person
Bank(s)
Others


  Brand Name Product Description Annual Volume Produce (Yes/No)
1.
2.
3.
4.
5.
6.


  Direct Route Sell Pre-sell Tell-sell
1.


  Number Mfg./Type Body Type Ton Capacity Average Age
1.
2.
3.
4.


  Land Size Building Size Age Owned or Leased? #Loading Docks: Truck Drive Thru
(Yes/No)
1.



  Total Number Now Servicing
Supermarkets or Chain stores
Grocery and Food stores
Mass Merchandisers
Other
Convenience Stores
Vending Locations
Other

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 Yes No


  Number Owned Purchsed 12 Mos.
Vending Machines - Bottle
Vending Machines - Can
Coolers - Glass Door
Coolers - Chest Type
Pre - Mix Units
Post - Mix Units

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 Yes No

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 Equity Loan

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  Year 1 Year 2 Year 3
DOUBLE-COLA
DIET DOUBLE-COLA
SKI
SKI FLAVORS
CHASER
JUMBO FLAVORS
MINOKU
QUAD
ZILI
DOUBLE-DRY