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CMS 488355 <br />ATTACHMENT 1 — DISTRIBUTOR FORM <br />Manufacturer Name: GH Armor Systems, Inc. <br />(check one) <br />❑ The Distributor listed below is authorized to provide Goods and Services in <br />accordance with the NASPO ValuePoint Body Armor Products Master <br />Agreement. <br />❑ The Distributor listed below will no longer provide Goods and Services under <br />the NASPO ValuePoint Body Armor Products Master Agreement. <br />State(s) Serviced by <br />Distributor: <br />Distributor Name: <br />Address: <br />... <br />Phone (include Toll -Free, if <br />available): <br />Contact Person(s): <br />Email Address: <br />FEIN: <br />Distributor Website: <br />Signed:........................._........_.............. Date: <br />(GH Armor Systems, Inc. RepresenlaUve) <br />Signed: Date: <br />(Distribulor Representative) <br />(Print First and Last Name of Distributor Representative) <br />Pape 1-C <br />SWV Amwr Products RFP-NK-001, NASPO ValuePoint Master Agreement Terms and Cor dlt(ons <br />