Adaptiv Retailer Portal

Business information

Legal business name *DBA (if applicable)Business type *Years at this addressStreet address *City *State *ZIP code *Federal Tax ID (EIN)D&B numberResale certificate numberBusiness phone *Email *Website

We’ll reuse this email in the remaining contact fields. You can change any prefilled address.

A valid, approved resale certificate is required before the account can be approved or place wholesale orders.

Primary delivery address

Complete this section if deliveries go somewhere other than the business address

Delivery contactPhoneDelivery days and hoursSpecial delivery instructionsStreet addressCityStateZIP code

Do you have additional ship-to locations? No Yes

If yes, we’ll collect the additional delivery locations during review.

Primary contact

Name *Title *Email *

Accounts payable

NameEmail

Store locator contact