"Purchasing Quotes and Questions"

           

CounterAct is available from local agents or should we not have representation convenient to your location you may purchase directly from us. Since we make such a wide variety of anti-corrosion systems for everything from ATVs to "Terex Titans" we want to insure that you obtain just the right system for your vehicle. Before purchasing please complete the form below and e-mail it to us so that we can assist you in finding just the right CounterAct system for your vehicle.

In addition to using this form you may choose to e-mail us at: counteract@counteractrust.com

(NOTE:  Please provide us with all the necessary information to address your specific inquiry and reply to your request. Your name, city, state or province and e-mail address are required in order for us to reply to your inquiry or refer you to a local CounterAct agent.)

Required fields are marked with an asterisk *

Please use this form to receive our recommendation about the correct CounterAct system for your particular needs and to learn the location of your nearest CounterAct agent. We will respond  at our earliest opportunity with recommendations and pricing. Additionally you may contact us at counteract@counteractrust.com or call us toll free.

  1. Please provide the following contact information:

    Make sure to include your name, address and e-mail address

    Name *
    Title
    Organization
    Street Address
    Address (cont.)
    City *
    State/Province *
    Zip/Postal Code
    Country
    Work Phone
    Home Phone
    FAX
    E-mail *
    URL

  2. I am inquiring about a CounterAct system for:


  3. My vehicle make/equipment manufacturer is:


  4. My vehicle/equipment model, year and description is


  5. My vehicle/equipment is exposed to one or more of the following conditions:

    driven high miles
    winter road salt
    high heat and humidity
    proximity to ocean or beach
    off road use
    abrasive environment
    commercial or work use
    air pollution

  6. You may be eligible for one of CounterAct's standing discounts. Are you a member of one or more of these groups?

    AAA
    AARP
    active duty U.S. military
    repeat CounterAct customer

  7. CounterAct offers discounts to Police and Fire Depts. as well as many government and non-profit groups. If you are purchasing for one of these groups please indicate below and list your organization and title in section 1 of this form

    Police or Fire Dept.
    government, municipal or non-profit entity

Copyright © 2002 [CounterAct]. All rights reserved.
Revised: September 13, 2006

Home