• I have read the promotion rules and understand that by purchasing products featured in the Supplier Point Book (available at www.birite.com), I will earn Award Points that I can redeem for valuable merchandise or travel awards.

    If premium merchandise or travel awards are to be received, I represent and warrant to BiRite that I am fully and legally authorized and entitled by applicable law and by my employer (listed above by account name) to receive such premium awards.

    I also understand that my account status must be current in order to be eligible to receive any Awards from the BiRite Bonus promotion.

    Applicable law may prohibit public agencies or entities, or their employees or representatives, from receiving premium awards. Private business may also prohibit their employees from participating in premium award promotions. Applicable taxes are the sole responsibility of the Award winners.

    All Health Care providers should indicate this status below so that they can take advantage of the Safe Harbor redemption option.