Non-Resale Reminder Form

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NIAGARA BOTTLING, LLC Product Disposition and Non-Resale Policy

Please be advised that due to concerns related to product liability, trademark protection
and/or licensing agreements, for all private label and Niagara products which are distressed,
damaged or otherwise rejected, any shipments that are not returned to a Niagara facility, for
whatever reason, must be properly disposed of. Product cannot under any circumstance ever
be re-sold or donated.

In the event that a distressed, damaged or otherwise rejected shipment is not returned to
a Niagara facility, Niagara requires written verification signed by an authorized agent of the
Carrier confirming final disposition of the product. This form must be returned within 24 hours.

Please acknowledge your understanding of this Policy by filling out this form and
returning a signed copy.

PRODUCT INFORMATION CARRIER INFORMATION

Carrier:
PO #: ___________________________

Lot Code: _______________________ Authorized Signature:


(Located under barcode on external pallet
label)

Quantity: ________________________ Title:

Approved Disposal Location:


Date:
1 Sculley Rd Ayer, MA

Please return the completed form to:


Email: [email protected] &
[email protected]
Fax: 909-354-3590

By signing this document, I understand, acknowledge and agree to Niagara’s Policy


regarding non-resale and disposition of private label and Niagara product. I agree to defend
and indemnify Niagara for any and all costs (including reasonable attorney fees) relating to
any breach of this Policy.
Tel 909.230.5000 Fax 909.354.3590 l 2560 E. Philadelphia St. Ontario CA 91761 l www.niagarawater.com

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