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DOLLAR COIN BULK PURCHASE PROGRAM 801 9th Street (Department of the Treasury - U.S. Mint)

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DOLLAR COIN BULK PURCHASE PROGRAM
801 9th Street NW, Washington, DC 20220-0001
Phone (202) 354-8316 l FAX (202) 756-0356 l DollarCoinBulk@usmint.treas.gov
1. To place an Order, review the process below, complete the order form, sign and date the form.
• Pu
rchase the minimum of one bulk bag, which contains 140,000 coins. Orders may be accepted and entered on
e
week prior to the product release date and picked up on or after that release date, until inventory is depleted.
• Pa
y for the coins at face value ($140,000), plus a premium fee, which equals 8.5% of total order valu
e
($11,900 per bag). Total price for each bulk bag $151,900.
• Pa
y in full and in advance via electronic wire funds transfer to the United States Mint
.
• Assume all shipping costs and arrange pick up to receive coins at the dock of United States Mint facilities in
Ph
iladelphia or Denver for coins manufactured in Philadelphia or Denver, respectively
.
- Customer will contact the United States Mint facility to 1) obtain instructions for pick up, 2) arrange carrier
ap
pointment, truck inspection, and driver clearance, and 3) coordinate customer/carrier product pick u
p
ap
pointment date/time
.
• Th
e order will be released after all pre-arrangements are fulfilled (e.g., the electronic funds transfer has bee
n
re
ceived, the shipment is ready, and clearances confirmed)
.
2. Pl
ease fax the order form to (202) 756-0356 or by email to DollarCoinBulk@usmint.treas.go
v
3.
If
you have any questions, please call the program office at (202) 354-8316 or b
y
Do
llarCoinBulk@usmint.treas.go
v
Dollar Coin Bulk Bag Order
Please Check: ______ New Customer or ______ Existing Customer #____________________________________
Date _______________________________ Contact Name _________________________________
Company Name _______________________________ Phone # ______________________________________
Tax Identification Number _________________________ Email Address _________________________________
Bill to and Ship to Address: Anticipated Pick-Up Date ______________________
Bill To: ________________________________________________________________________________________________
Ship To: _______________________________________________________________________________________________
Line
Item#
Item Description
Product
Mintmark
Quantity
Price
Per Bag
Total
1 Bulk Bag
(140,000 coins per bag)
Native American $1
or
American Innovation $1
P or D
140,000
1
2
3
4
02-12-2019 Page 1 of 2
Company Name _______________________________
Ordering Terms:
No returns or refunds are permitted on the Dollar Coin Bulk Purchase Program (Native American or Amerian
Innovation $1). Payment is required by electronic funds transfer in advance in accordance with the United States
Mint's official written procedures. Orders are not valid until accepted by the United States Mint. The United States
Mint reserves the right to limit quantities and may discontinue accepting orders at any time. The United States Mint
will refund payments made for orders not accepted. The United States Mint reserves the right to accept or reject
orders in any combination or option(s) it determines to be in its best interest. In the event a requested product is sold
out or is not available, the United States Mint reserves the right to either process partial orders and make refunds, or
reject orders in their entirety. Any dispute hereunder shall be governed by and construed only under Federal law.
Coins are available FOB origin from designated United States Mint facility.
Signature: ________________________________________________________
For more information on the Dollar Coin Bulk Purchase Program, please visit https://catalog.usmint.gov/bulk-
purchase-program-landing.html
DO NOT WRITE BELOW THIS LINE
---------------------------------------FOR INTERNAL UNITED STATES MINT USE ONLY---------------------------------------
Date Order Received
_______________________________
System Order#
Philadelphia Denver
__________________________________________________ _______________________________________________
__________________________________________________ _______________________________________________
___________________________________________________ _______________________________________________
__________________________________________________ _______________________________________________
___________________________________________________ _______________________________________________
Date processed _____________
Processed by _______________
02-12-2019 Page 2 of 2
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DOLLAR COIN BULK PURCHASE PROGRAM 801 9th Street (Department of the Treasury - U.S. Mint)

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Completed 19 July 2020

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