SIGNATURE RELEASE AUTHORIZATION AND INDEMNIFICATION AGREEMENT FOR RECIPIENTS

BEFORE USING THIS FORM, PLEASE READ THE FOLLOWING:
1. YOU MUST CALL (909) 613-1999 OR EMAILto receive an authorization code before we can proceed with
your signature release authorization or with using your FedEx or UPS account. Office hours are: 7:30 AM - 3:30 PM Pacific Time Monday thru Friday.

2. This form can ONLY be used for FedEx or UPS GROUND Services - Please fax to CPD Industries (909) 613-1979 or email to

3. FedEx or UPS will not deliver any packages without signature for special delivery such as: FedEx Standard Overnight, FedEx 2nd Day,
FedEx Express Saver, UPS Next Day, UPS 2 Days, or UPS 3 Day.

4. All packages with a declared value of $500USD or greater require a signature.

5. Your completed Signature Release Authorization MUST be submitted at the time of order placement.

6.
We do not guarantee that your request for no signature will be processed if your form is received after the order date.

7. Please note delivery instructions cannot be changed once an order is shipped.

AUTHORIZATION CODE: ___________________

This agreement is entered into this ___________ day of _______________________ between CPD Industries (hereinafter "CPD")  and
_______________________________________ (hereinafter "Recipient")

RECITALS

FedEx & UPS provides a high-priority package ground delivery service, which requires upon delivery obtaining a signature. The signature provides
proof that the package has been delivered.

By signing this Authorization and Agreement, however, Recipient allows CPD to change its usual policy and deliver your packages according to
these instructions: delivery of his packages to certain places without obtaining a signature by FedEx or UPS.

Therefore, for and in consideration of the mutual covenants contained herein, the parties hereto agree as follows:
1. If you request a PROOF-OF-DELIVERY, you will receive a receipt listing the designated place of delivery. This shall constitute proof-of delivery in
accordance with Recipients instructions.
2. You acknowledge that when FedEx or UPS have delivered the package according to the terms of this Agreement, you agree to indemnify CPD
and hold CPD harmless from all liability claims, including any expenses, attorney's fees or other litigation costs due to any loss and/or damage to
shipments delivered by FedEx or UPS under this Agreement.
3. If you want to cancel this Agreement, or if your business closes or relocates, you must give CPD prior notice of at least 7 calendar days. Otherwise,
this Agreement becomes immediately null and void

This agreement, executed as of the date appearing above, shall not become binding upon CPD until written approval via fax or email is given to
Recipient.


ORDER/ INVOICE NUMBER: _________________________________________

 

RECIPIENT NAME: _______________________________________ COMPANY: _________________________________________

 

ADDRESS:_____________________________________________________________________________________

 

CITY:__________________________________  STATE: _______________________  ZIP CODE:_____________________

 

DAY TIME PHONE NUMBER: ____________________________           FAX NUMBER: _________________________

 

RECIPIENT FEDEX or UPS ACCOUNT NUMBER: _____________________________

This form can only be used for FedEx or UPS FedEx GROUND SERVICE - FedEx or UPS will not deliver any packages without
signature for special delivery
such as: FedEx Standard Overnight, FedEx 2nd Day, FedEx Express Saver, UPS Next Day,
UPS 2 Days, or UPS 3 Day.

 

RECIPIENT SIGNATURE: _______________________________________________

 

OFFICE USE

APPROVED BY:  ___________________________________________  DATE: _______________

Terms and Conditions
Copyright 2000 - 2015 CPD Industries
Last modified: 02/02/2015


CPD Industries is not affiliated with Pelican Products.
All trademarks are registered and/or unregistered trademarks of Pelican Products, Inc., its affiliates or subsidiaries.