2014 Xcel Energy Lighting Program ORDER FORM DUE: ASAP For Promo: 1/1/14 – 12/31/14

1. 2014 Xcel Energy Lighting Program ORDER FORM DUE: ASAP For Promo: 1/1/14 – 12/31/14 *Sales Data is required Monthly to participate. NO EXCEPTIONS! Order Information: Ship To: ________________________ Contact Name: ______________________________ ________________________ Phone #: _____________________________ ________________________ PO#: _____________________________ Store #: _____________________________ Fax Order Forms To : 562-908-6360 - Fax 562-463-2852 – Phone oguerrero@feit.com - Email Promotion Contact: Daisy Soza 562-908-6360 - Fax 562-463-2852 - Phone dsoza@feit.com REQUIRED FOR ORDER TO BE PROCESSED AND SHIPPED: I AGREE TO PROVIDE SALES DATA ON THE SALE OF ALL THE BULBS ORDERED FOR THIS PROMOTION. IF I FAIL TO PROVIDE THE REQUESTED DATA, I UNDERSTAND THAT I WILL BE RESPONSIBLE FOR PAYING THE FULL PRICE OF THE BULB (REGULAR EVERYDAY COST INSTEAD OF DISCOUNTED PROMO COST). I UNDERSTAND I MUST RETAIL THE BULBS AT THE LEVELS DETAILED ABOVE. Signed: _______________________________ Print: _____________________________ Date: ________________________________ Bulbs are available on a first come, first serve basis. Once Feit / Ace sells through our sponsored discounted allotment of bulbs, no additional bulbs will be available. Please order accordingly.