Accounts Payable Contact. Name: Email: Phone:
Accounts Payable Contact. Telephone Number Fax Number X.X. Xxx Xxxxxxx Xxxx Xxxxx Xxx Code Office Telephone Mobile Fax Xxxxxx Xxxxxxx X.X. Xxx Xxxxxxx Xxxx Xxxxx Zip Code Account Number Contact Name Contact’s Telephone Authorization to release banking information:
Accounts Payable Contact. Phone Number: If this is a branch or subsidiary, please list parent company, location and phone number: Date Business Commenced: Sole Proprietorship: Partnership: Corporation: Other: Federal ID Number: DUNNS Number: THE FOLLOWING BUSINESS AND CREDIT INFORMATION MUST BE COMPLETED IN FULL Billing Address: City: State: Zip Code: Please list company officers or principals: Name: Title: Phone: Name: Title: Phone: Name: Title: Phone: Bank Name: Bank Location: Phone Number: Officer: Account Number: BUSINESS/TRADE REFERENCES Company Name: Address: City: State: Zip Code: Phone Number: Fax Number: Email Address: Company Name: Address: City: State: Zip Code: Phone Number: Fax Number: Email Address: Company Name: Address: City: State: Zip Code: Phone Number: Fax Number: Email Address: AGREEMENT By submitting this application, I authorize Kenco Bucket Trucks, LLC (“KENCO”) to make inquiries into the banking and business/trade references that I have supplied. I represent and warrant that all the information on this form is correct and accurate to the best of my knowledge. I further acknowledge the terms of payment for open accounts are NET 30 and effective 30 days after invoice date. Any unpaid balance will bear a finance charge at the lesser of the maximum rate allowed by applicable law, or 1.5% per month, which is an annual percentage rate of 18%, and all future jobs will be on a prepaid basis only. By signing below, the authorize Company representative is fully accepting the terms and conditions set forth in this new customer packet. Signature: Title: Print Name: Date: CREDIT APPLICATION ® BILLING REQUIREMENTS To be filled out by accounts payable representative.
Accounts Payable Contact. Tel: ...................................................
Accounts Payable Contact. PHONE NO. LIST NAME(S) AND TITLES(S) OF CORPORATE OFFICERS, PARTNERS, OWNER NAME / TITLE HOME ADDRESS / ZIP CODE SOC. SEC. #
Accounts Payable Contact. (May leave blank for non-fee Membership)
Accounts Payable Contact. Client will provide DDS with the name and contact information of a single point of contact with responsibility for Client’s accounts payable, to whom DDS will submit all invoices. Client will identify an accounts payable single point of contact for itself and, if applicable, for each of its Affiliates receiving Services under this Agreement.
Accounts Payable Contact. FULL NAME TITLE
Accounts Payable Contact. Title:......... ... ... ... ... ...... ... ............. Email address for invoicing...... ... ... ... ... ... ... ... ...... . .. .. . ... . . . .... . ... . . .. . .. ... ... .. . ... .. . ... .. .. . TRADE REFERENCES NAME OF COMPANY CONTACT PHONE NO Anticipated weekly trading : $............. ......... ........ ....
Accounts Payable Contact. Email ............................................................................................ Full Name of Directors/Owners Private Address Telephone Number ....................................................................................... ........................................................................ ............................................... ....................................................................................... ........................................................................ ............................................... ....................................................................................... ........................................................................ ............................................... Nature of Business ................................................................................................................................................................................... No. of Years Established ............................................................... No. Of Employees ………………………………..............................….. Are Premises Owned? Leased? Term Of Lease ……………………………………................................… Are You Self-Employed? A Company? A Business? A.C.N. A.B.N. Web Address ……………………………………......................................... Email Address ………………………………………..........……….............. Have You, The Company or Business Traded With Us Before? Yes No Name of Bank ……………………………………………….....................…………………………………………………………………………………………………… Branch ………………………………………………………….......................... Account No …………………............................................................. Name of Referee Addresss Telephone Number ....................................................................................... ........................................................................ ............................................... ....................................................................................... ........................................................................ ............................................... ....................................................................................... ........................................................................ ...............................................
