Authorized Servicing Dealer & Representatives Form

Servicing Dealers
Per the requirements listed in the Special Contract Conditions, section 5.15, 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: Hertz Furniture Systems                                                             
Dealer Address: 17430 NE 7th Ct
City, State, Zip Code: Miami, FL 33162
Office Phone/Fax: 786-251-3596/305-655-9925
Email Address: elliotg@hertzfurniture.com                                                        
Contact Person: Elliot Grossbard
Vendor Tax ID Number: 22-3795977

*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: Evan Bash
Position title: Sales Manager                                                                           
Address: 7426 Sparkling Lake Road, Orlando FL, 32819
Office phone / fax: 800-526-4677/800-526-4677
Cell phone / pager: 407-325--7135
Email address: ebash@hertzfurniture.com
Geographic area of territory: Central Florida