NAME:       POSITION:

COMPANY:       DEPARTMENT:

ADDRESS:       CITY:

STATE:       ZIPCODE:       OFFICE#:

FAX:     PAGE/CELL#:    E-MAIL:

WEB SITE:       SERVICE INDUSTRY:

VENDOR RATES:   SIGNATURE (Initials):

By signing below, I agree to all Policies and Procedures as it relates to doing business with

the MAE Corporation USA & its subsidiaries and divisions.

I also agree to notify the MAE Corporation of any changes in prices and / or company policies

as it relates to my business and services provided.

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