COMPANY NAME ____________________________________________
ADDRESS ____________________________   PHONE _____________
                ____________________________   FAX _______________



BILLING ADDRESS _________________________________________
(if different than above) _____________________________________		



FEDERAL IDENTIFICATION NUMBER ____________________________
HOW MANY YEARS IN BUSINESS _______________________________
NATURE OF BUSINESS _______________________________________
                                 _______________________________________



PRINCIPALS: Name ____________________ Title _____________
                    Name ____________________ Title _____________



BANK NAME ___________________________ PHONE _____________
 ADDRESS ____________________________ STATE ____
 CITY ________________ ZIP CODE _____________
BANK ACCOUNT NUMBER _____________________



TRADE REFERENCES:

NAME                              ADDRESS                           PHONE

_________________________________________________________
_________________________________________________________
_________________________________________________________



I understand that OPI's terms and conditions of payment
are NET 20 DAYS and I agree to remit within the NET 20 DAYS.



______________________    ___________________  ___________
Signature                             Title                             Date