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MDM Commercial Enterprises, Inc.

Ordering Instructions Form

BIDDER: MDM COMMERCIAL ENTERPRISES, INC

VENDOR TAX ID NUMBER: 59-3040331

Ordering Information:

Please provide the following information about where Customers should direct orders.You must provide a regular mailing address and email address.If equipped to receive purchase orders electronically, you may also provide an Internet address. NOTE:Duplicate as necessary for multiple ordering locations.

Name: KATHY WHITMAN

Title: SERVICE MANAGER

Street Address or P.O. Box: 2320 SOUTH 3RD STREET

City, State, Zip: JACKSONVILLE BEACH , FL32250

Email Address: Kathy@mdmcommercial.com

Phone Number: 904-241-2340 ext 105

Toll Free Number: 800-359-6741

Ordering Fax Number: 904-247-7735

Internet Address: www.mdmcommercial.com

Federal ID Number: 593040331

Remit Address: same

City, State, Zip: same

Please identify the person who will be responsible for administering the Contract on your behalf if award is made, and include an emergency contact phone number:

Name: Dana Romano

Title:Sales Consultant

Street Address: 2320 South 3rd Street #15

E-mail Address: dana@mdmcommercial.com

Phone Number(s): 904-241-2340 ext 112

Fax Number: 904-247-7735

Please be advised that vendors are responsible for verifying and maintaining the correct contact and address information within their MyFloridaMarketPlace vendor registration account.Failure to do so may result in the vendor being deemed ineligible to conduct business with the State of Florida.

Authorized Servicing Dealer & Representatives Form

SERVICING DEALERS

Per the requirements listed in the Special Contract Conditions, 5.9 Factory Service Requirements, please list below all authorized servicing dealers that will be providing service/product by participating on your State Contract.*Please note that any dealer receiving orders on this contract must be registered in MyFloridaMarketPlace.

The following information must be completed in its entirety for each dealer:

Dealer Name: MDM COMMERCIAL ENTERPRISES, INC

Dealer Address: 2320 S 3RD STREET

City, State, Zip Code: JACKSONVILLE BEACH, FL 32250

Office Phone/Fax: 904-241-2340FAX 904-247-7735

Email Address: steve@mdmcommercial.com

Contact Person: Steve Austin

Vendor Tax ID Number: 593040331

*Please identify any CMBE (Certified Minority Business Enterprise) dealers participating in this contract.

MANUFACTURER REPRESENTATION

Please list below all field representatives (directly employed by the manufacturer) that will be participating on your State Contract team.

Manufacturer's representative: Mel Harris - LG

Position title:PTAC Business Development Manager

Address: 920 Sylvan Ave.

City, State, Zip Code: Englewood Cliffs, NJ 07632

Office phone / fax: 508-875-5985

Cell phone / pager: 904-710-5823

Email address: mharris@lge.com

Geographic area of territory:U.S.

(This form may be duplicated as necessary.)