LICENSING INFORMATION
Delivery Date _____________________________
DEALER _________________________________
SOLD TO _________________________________
Address __________________________________ Address
__________________________________
City ______________________________________ City
______________________________________
State ____________________________________ State
____________________________________
Zip Code _________________________________
Zip Code _________________________________
Phone Number ____________________________
Phone Number ____________________________
Unit’s Model Number ______________________
Unit’s Serial Number _______________________
MERIDIAN MANUFACTURING INC.
2902 EXPANSION BLVD. STORM LAKE, IA 50588
T: (800) 437-2334 P: (712) 732-1780 F: (712) 732-1028
www.meridianmfg.com [email protected]
CERTIFICATE OF ORIGIN
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