AMERICAN GRITREVOLUTIONARYENGINEERING

Government Order / Discount Request

Welcome — we’re honored to support public servants who keep our communities running at the local, state, and federal level. This form helps us gather the details needed to prepare an accurate agency quote, and it also serves as an application for our Government Agency Discount Program.

Note: Please do not submit payment card numbers in this form. Payment arrangements will be coordinated separately after your request is reviewed.

Agency Type

Federal State Local

Agency Information

Agency Name *

Branch / Division

Agency Phone

Address Line 1 * Address Line 2

City *

State *

ZIP *

Contact / Requestor

Name *

Title

Email *

Phone *

Office Ext

Cell

Billing Address

Billing address is the same as agency address

Shipping Address

Shipping address is the same as agency address Shipping address is the same as billing address Care of (optional) (If this should be delivered to a specific person/department.)

Product Selection

Add one line per item variant: select the product, marking text (or CUSTOM TEXT), text color, and quantity. For multiple unique, non-sequential names or badge numbers, we’ll collect the full list before production.

#	Product	Text	Custom Text	Text Color	Qty	Remove

Order Notes (optional) (Use this for special instructions, packaging notes, or anything we should know before quoting.)

Payment Information

Preferred Payment Method * Request Net Terms (Net 30) (optional)

If Net 30 is requested, we’ll review it during the quote process.

Payment Notes (optional)

LEO / Agency Credential Policy

Any TRAC Tag that will contain an agency name, badge number, or anything related to law enforcement / government agency identification must include active credentials. Examples: agency ID card, procurement letter on agency letterhead, etc. This helps prevent unauthorized impersonation.

This order includes TRAC Tag text that identifies an agency / law enforcement credentials (agency name, badge number, etc.)

Uploads

Tax Exemption (optional) (PDF/JPG/PNG/DOC/DOCX) Purchase Order (optional) (PDF/JPG/PNG/DOC/DOCX)

Additional document (optional)

Signature

Typed Name * Date * Draw Signature * (mouse or touch)

Signature not captured yet.

I certify that the information submitted in this request is true and accurate to the best of my knowledge.

KAAMB Industries LLC designs and produces proprietary gear using in-house CAD development and rapid prototyping. We combine digital precision with real-world testing to deliver rugged, reliable products for the range, the job site, and the home.