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Account Registration All fields are required for registration Select Program(s) Additional programs can be selected at a later time BERGSTROM AFTERMARKET SYSTEMS BERGSTROM BUS A/C BERGSTROM eClimaCoach BERGSTROM eCoolPark BERGSTROM HVAC PARTS BERGSTROM PHOENIX BERGSTROM SSI DTNA PARKSMART DUAL HVAC SYSTEM OSHKOSH Other Company Name Address City State/Province Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Islands Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Zip Code Contact Name Phone Number E-Mail Address A W-9 form is required for the account. Please fill out a W-9 form and email to warranty@bergstrominc.com or by fax to 815.874.2144

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