APPLICATION FOR CREDIT
Firm Name:_______________________________________________________________
Proprietors or Partner's Name_________________________________________________
Billing Address:____________________________________________________________
City:_______________________State:__________________Zip:____________________
Phone #___________________________Fax #___________________________________
At present location since:_____________________Year established:_________________
Incorporated?________________________State:_________________________________
REFERENCES: (Give only names of those you purchase from on open account)
1.)Name:_____________________Phone:_________________Fax:__________________
Adress:______________________City:___________________State:________Zip_______
2.)Name:_____________________Phone:_________________Fax:__________________
Adress:______________________City:___________________State:________Zip_______
3.)Name:_____________________Phone:_________________Fax:__________________
Adress:______________________City:___________________State:________Zip______
Bank Branch:____________________________Adrress:__________________________
City:____________________State:__________Zip:__________Phone:_______________TERMS AND CONDITIONS
All invoices are due 30 days from date of invoice. An additional 1 ½ percent finance charge will be charged to all accounts not paid within 30 days, and each month thereafter until paid. In the event legal action is required to enforce any of the terms of purchase or obligations created herby or hereinafter, legal action will be commenced. In any such action American Rock, LLC will be entitled to reasonable court costs and attorney fees.
IF ANY CHARGE ACCOUNT DOES NOT COMPLY WITH THESE TERMS THAT ACCOUNT WILL RETURN TO A C.O.D. STATUS UNTIL PAST DUE AMOUNTS ARE PAID IN FULL. ALL DELINQUENT ACCOUNTS ARE SUBJECT TO REVIEW AND REINSTATEMENT TO CHARGE STATUS.
AGREEMENT:
I/We understand, acknowledge, and accept American Rock's terms of credit and certify that the information given herein is correct.
| ___________________________________ | ___________________________________ |
| Signature | Title |
| ___________________________________ | |
| Print Name | |
| ___________________________________ | |
| Date |
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