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Sullivan Concrete Credit Application

Company Name:
Address:
City/State/Zip:
Telephone:
Fax:
Person to contact
regarding billing:
Sole Proprietorship:   Partnership:   Corporation:
Federal ID#:
Credit Limit Requested:

Owner/Officer:
Social Security #:
Title:
Address:
City/State/Zip:
Telephone:

Owner/Officer:
Social Security #:
Title:
Address:
City/State/Zip:
Telephone:

 
 Trade References
1. Name:
Address:
City/State/Zip:
Telephone:
Fax:

2. Name:
Address:
City/State/Zip:
Telephone:
Fax:

3. Name:
Address:
City/State/Zip:
Telephone:
Fax:

4. Name:
Address:
City/State/Zip:
Telephone:
Fax:

 Bank References
Type of Account:
Phone:
Account Number:
Name of Bank:
Address:
Contact Person:

Type of Account:
Phone:
Account Number:
Name of Bank:
Address:
Contact Person:

 TERMS
Credit terms are net 15 days on receipt of statement. Invoices not paid within 30 days of statement billing date will be assessed a 1½% per month finance charge. All accounts over 30 days will automatically be shipped on a C.O.D basis and relinquishes their privileges on credit until satisfactory credit is restored.

I/ We understand and agree that the information provided is for the purpose of obtaining merchandise credit. I/ We further understand and agree that all accounts or monies owed to Sullivan Concrete Inc shall be paid in accordance with credit terms stated above and agree to pay all costs of collections including but not limited to court cost and/or attorney fees etc. that may be incurred. I/ we authorize investigation of all credit references listed.

If this application is approved by Sullivan Concrete Inc., the applicant and Guarantor(s) expressly understands and agrees that any and all transactions between Sullivan Concrete Inc. and the applicant which leaves an outstanding balance owed to Sullivan Concrete Inc. which collection on said outstanding balance owed requires Court intervention, the applicant and Guarantor(s) consent to the jurisdiction being in the New York State courts, and venued in Sullivan County.

The approved applicant and Guarantor(s) expressly agree to provide Sullivan Concrete Inc. a fully executed copy of the contract that forms the basis for the requested materials, whether same be a prime contract or a subcontract.

 GUARANTEE
I/We undersigned do hereby guarantee payment as individuals of any indebtedness incurred by virtue of any and all credit extended in accordance with the above agreement and all of its terms and conditions.

     
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