CREDIT APPLICATION & AGREEMENT (PLEASE PRINT OR TYPE CLEARLY)Credit Application & Agreement • March 2nd, 2020
VITRUM INDUSTRIES LTD. VITRUM HOLDINGS LTD.Credit Application & Agreement • August 30th, 2016 • British Columbia
Legal Name Year Started Trade Name DUNS # Tel. No. Fax No. Cell No. Billing Address: City Prov/State Postal/ZIP Country Shipping Address: City Prov/State Postal/ZIP Country
CONFIDENTIAL CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • April 20th, 2018 • British Columbia
Type of Business: Ownership: Government Agency Corporation Partnership Limited Company Proprietorship Projected Annual Purchases $ Would you like an order confirmation sent? (Please check one)
Credit Application & AgreementCredit Application & Agreement • May 3rd, 2019 • Iowa
Applicant agrees to pay the entire debt that Applicant shall incur on any charge that may be granted to Applicant’s account, including without limitation, all collection costs and attorney fees, plus any finance charges that may be imposed in accordance with the general terms and conditions of this Credit Application & Agreement attached hereto and incorporated herein by reference. Applicant understands that accounts are to be paid in full each month and that incurring a finance charge is not an alternative to payment when due.
ROCKINGHAM COOPERATIVE CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • January 4th, 2017
Revolving Account (minimum payment of $25 or 1/12th of balance (not for farm or business accounts) 30-Day Open Account (balance payable in full within 30 days of billing date)
CREDIT APPLICATION AGREEMENTCredit Application Agreement • March 17th, 2020
Has the Client, and or its shareholders/members or representatives, issued/signed any Guarantees or other forms of security in favour of other
Please note a bank and trade reference is acceptable; however, all areas not covered on bank and trade form must be filled out.**Credit Application / Agreement • March 17th, 2006
Business Name: Physical Address: Phone #: Fax #: A/P Contact: Billing Address: A/P Phone #: A/P F Primary Contact: A/P E-mail: □ Fax □ E-mail Business Type: □ Sole Proprietor □ Partnership □ Corporation □ LLC □ Government □ Non-profit Business Description: Anticipated Credit Limit: $ Purchase Order Required? □Yes □No Job # Or Name Required ? □ Yes □ No Tax Exempt? □ Yes □ No Liability Insurance Coverage? □ Yes □ No ** Equipment Protection Plan for Rental Equipment? □ Yes □ No **(If yes, please attach insurance certificate.) Bonding Company (Name/Address):
ELMHURST-CHICAGO STONE CO.Credit Application & Agreement • May 23rd, 2023
ContractCredit Application & Agreement • July 26th, 2018 • Queensland
Credit Application & Agreement The undersigned person/company is applying for credit with and agrees to abide by the standard terms and conditions attached to this agreement. Supplier’s Name Fusion Qld Pty LtdACN 118 560 348 ABN 42 987 067 369PO Box 151, Noosaville Qld 4566T +61 7 5474 3000F +61 7 5474 1700E accounts@fusionqld.com.au Customer’s Name: Trading Name: ABN: ACN: Postal Address: Delivery Address: Phone: Fax: Email: Website: Accounts Contact: Sales Contact: Type of Business: Date Business Established: Credit Requested: $ Type of trading entity: ❑ Partnership ❑ Trust (nominate one) ❑ Company ❑ Discretionary Trust ❑ Sole Trader ❑ Unit Trust Details of all Partners/Directors/Owners/Trust Members/Beneficiaries Name Address Position 1. 2. 3. 4.
Confidential Credit Application & AgreementCredit Application & Agreement • November 8th, 2022
This Credit Application/Agreement to BD in Canada must be fully completed, signed and returned before your credit request can be considered. This agreement governs all sales to you/your organization of BD in Canada products/services on terms and conditions set forth by BD in Canada or which may be established as policy from time to time by BD in Canada. Sales representatives or agents of BD in Canada are not authorized to amend or change the terms of sale or other terms and conditions of this agreement. The requested information is for BD in Canada’s internal use only and will be handled in the utmost confidentiality.
Credit Application / AgreementCredit Application / Agreement • January 27th, 2015
This credit application must be fully completed, signed and returned before your request will be considered. The undersigned hereby agrees that Stuller, Inc. is due and payable at its principal office in Lafayette, Louisiana, and that this application serves as an agreement for the sales of goods and or services.
MR LOGISTIC SOLUTIONS LLC CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • March 7th, 2022
Applicant authorizes MR LOGISTIC SOLUTIONS LLC to obtain credit information about applicant, verbal or written, from the above-named references. When credit is extended, applicant agrees to pay for all freight and related services arranged or provided by MR LOGISTIC
CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • May 13th, 2022
CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • June 26th, 2014
Applicant authorizes Fast Freight Systems, Inc. to obtain credit information about applicant, verbal or written, from the above-named references. When credit is extended, applicant agrees to pay for all freight and related services arranged or provided by Fast Freight Systems, Inc. at the agreed rates. Payments are due within 30 days from invoice date. Applicant’s payment obligations to Fast Freight Systems, Inc. shall not be subject to the receipt of payment by applicant from another party and any set offs or deductions are prohibited. In the event of non-payment or other violation of this agreement, applicant will pay all collection costs and attorney fees, and consents that any legal action may be within the venue of any state in which Fast Freight Systems, Inc. has offices. This agreement is incorporated into all transportation and other related agreements entered into by the parties, verbal or written. Applicant represents that the person signing this agreement is authorized to do
CREDIT APPLICATION AGREEMENTCredit Application Agreement • April 3rd, 2018
APPLICATION DISCLOSURE AND AGREEMENTCredit Application Agreement • March 20th, 2018
You understand and agree that you are applying for credit by providing the information to complete and submit this credit application. We may keep this application and any other application submitted to us and information about you whether or not the application is approved. You certify that the information on the application and in any other application submitted to us, is true and complete. You understand that false statements may subject you to criminal penalties.
Drillers Service, Inc.Credit Application & Agreement • July 28th, 2016
TERMS: Applicant and the undersigned principal(s) represent that the information provided in this Credit Application and Agreement (“Agreement”) is true and correct and is given to induce Drillers Service, Incorporated (“DSI”) to extend credit to Applicant for commercial or business use only. Applicant authorizes DSI to make inquiry into any and all matters set forth in this Agreement and to obtain oral or written reports from any credit reporting agency or reference necessary for evaluation of Applicant’s credit history, business relationships and financial status and responsibility.
BUSINESS NAME ADDRESS CITY/STATE/ZIP TELEPHONECredit Application Agreement • July 9th, 2001
ContractCredit Application Agreement • August 15th, 2014
Sinofreight, LLC Credit Application AgreementPHONE (626) 271-9800 FAX (626) 271-9841 Business Contact Information Company Name: Parent Company: Proprietor/Partner’s Name(s): A/P Contact: Phone: Fax: E-mail: Physical Address: City: State: ZIP: Mailing Address: City: State: ZIP: Business and Credit Information Year Established? How long at current address? Is business incorporated? Corporation Number: Federal Tax ID Has company or owners ever filed Bankruptcy? Bank Name: Bank Address: Contact Name: City: State: ZIP: Phone: Type of account Account number Savings Checking Business and/or trade references COMPANY NAME: Address: City: State: ZIP: Phone: Fax: E-mail: Type of account: COMPANY NAME: Address: City: State: ZIP: Phone: Fax: E-mail: Type of account: COMPANY NAME: Address: City: State: ZIP: Phone: Fax: E-mail: Type of account: Agreement 1. All invoices are to be paid 15 days from the date of the invoice.2. Claims arising from invoices must be made within 15 days.3. By submitting
CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • December 29th, 2014
Email: accounts@weltradepackaging.com.au Tel: 07 5597 0102 Fax 07 3337 9841 CREDIT APPLICATION AGREEMENTCredit Application Agreement • March 8th, 2019
Credit is extended only in accordance with our standard terms of sale (attached). By signing and completing this form you acknowledge receipt and agree to the stated terms. Please return completed forms via email or fax/mail directly to Weltrade Pty Ltd (Weltrade). Where the applicant for credit is a Proprietary Company we will require the signed personal guarantee by the directors.
CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • June 26th, 2014
Applicant authorizes Gulf Line Transport, LLC to obtain credit information about applicant, verbal or written, from the above-named references. When credit is extended, applicant agrees to pay for all freight and related services arranged or provided by Gulf Line Transport, LLC at the agreed rates. Payments are due within 30 days from invoice date. Applicant’s payment obligations to Gulf Line Transport, LLC shall not be subject to the receipt of payment by applicant from another party and any set offs or deductions are prohibited. In the event of non-payment or other violation of this agreement, applicant will pay all collection costs and attorney fees, and consents that any legal action may be within the venue of any state in which Gulf Line Transport, LLC has offices. This agreement is incorporated into all transportation and other related agreements entered into by the parties, verbal or written. Applicant represents that the person signing this agreement is authorized to do so.
CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • July 2nd, 2018
☐ I will give Campbell Oil Company a certified funds deposit for a minimum amount of 50% of the credit limit requested above. Deposit amount is determined solely by Campbell Oil Company based on customer’s credit, references, and credit limit requested.
CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • August 27th, 2018
Nevada Contractors License# Business License# tfederal Tax I.D.# Email Address: Tax Exempt: Yes D No D How long in business? Purchase Orders Required Yes D No D
CREDIT APPLICATION AGREEMENTCredit Application Agreement • December 21st, 2015
Locations: Berkey, Bradner, Curtice, Graytown, Lemoyne, Lindsey, Oak Harbor, Perrysburg, Sugar RidgeCredit Application & Agreement • April 14th, 2017
CREDIT APPLICATION/AGREEMENTCredit Application/Agreement • July 12th, 2012
This Credit Application/Agreement to Al-Pack Enterprises Ltd which includes terms and conditions must be fully completed, signed and returned before your credit request can be considered. This agreement governs all sales to you of Al-Pack Enterprises Ltd goods or services on terms and conditions set forth by Al-Pack Enterprises Ltd. Sales representatives or agents of Al-Pack Enterprises Ltd are not authorized to amend or change the terms of the sale or other terms and conditions of this agreement.
CREDIT APPLICATION & AGREEMENTPlease indicate products you wish to purchase: Aggregate ☐ Ready Mix ☐Credit Application & Agreement • January 13th, 2022
In consideration of Aggregate Industries Management, Inc. (“AI”), subsidiary or affiliate of AI (hereinafter called “Vendor”) extending credit to the firm of , (the “Firm”); and in further consideration of Vendor providing materials and/or services to the Firm on credit; and relying upon the representations set forth in this credit application submitted by (the “Applicant”),
CREDIT APPLICATION & AGREEMENTCredit Application & Agreement • June 26th, 2014
Applicant authorizes Carolina National Transportation LLC to obtain credit information about applicant, verbal or written, from the above-named references. When credit is extended, applicant agrees to pay for all freight and related services arranged or provided by Carolina National Transportation LLC at the agreed rates. Payments are due within 30 days from invoice date. Applicant’s payment obligations to Carolina National Transportation LLC shall not be subject to the receipt of payment by applicant from another party and any set offs or deductions are prohibited. In the event of non-payment or other violation of this agreement, applicant will pay all collection costs and attorney fees, and consents that any legal action may be within the venue of any state in which Carolina National Transportation LLC has offices. This agreement is incorporated into all transportation and other related agreements entered into by the parties, verbal or written. Applicant represents that the person si
IT IS AGREED THAT THE PARTIES WHO HAVE APPENDED THEIR SIGNATURES HERETO ON BEHALF OF THE CUSTOMER:Credit Application Agreement • June 3rd, 2021
sender or consignee accepts that it shall be jointly and severally liable with the Customer for the due performance by the Customer of all its obligations under this agreement;
Credit Application AgreementCredit Application Agreement • June 12th, 2009
For the purpose of VIP Wireless providing products and services on credit, we submit the following information. We understand that this information will be kept confidential.
CREDIT APPLICATION AGREEMENTCredit Application Agreement • February 27th, 2020
The signature below is an acceptance of the terms and conditions set forth in this agreement and certification that information on this form is correct. By submitting this credit application, the above company and the undersigned authorizes Craig Bachman Imports, Inc. to obtain credit information from, but not limited to, financial institutions, business/trade references and credit bureaus, as well as periodic checks to determine our credit capabilities to Craig Bachman Imports, Inc. We agree to pay for previous, present, and future charges incurred by officer, employee or agent of the customer/organization within 30 days from the date of the invoices/charges. We agree to pay interest charges of 1.5% per month
PLEASE COMPLETE ALL SECTIONS OF THIS FORM FOR YOUR CREDIT APPLICATION TO BE APPROVED THIS AGREEMENT IS BETWEEN KELM HIRE P/L (“WE, US, OUR”) AND THE APPLICANT (“YOU, YOUR”)Credit Application Agreement • May 1st, 2019
Name: ACN: If Applicant is a Company, Company Name: ABN: Accounts Contact Name: Street Address: Postcode: Postal Address: Postcode: Telephone No: Accounts Email Address: Credit Limit required: $ If sole trader, please supply date of birth:
Credit Application Agreement for Public HospitalsCredit Application Agreement • December 5th, 2022
Credit Application & AgreementCredit Application & Agreement • January 20th, 2022
