Ironman Industrial Credit Application

Ironman Industrial, LLC

2131 Bayou Blue RD. Houma, LA 70364

Phone: 985-360-3333

Fax: 985-3063270
We hereby apply for the extension of credit by the above firm and submit the following information as a basis for your consideration of our application. You are hereby authorized to investigate this information pertaining to our credit and financial responsibility.
Firm's Legal Name:
Date:

MonthDayYear
Date
Operating Trade Name:
Phone:
Street:
City:
Zip:
Address

Mailing Address

Street Address Line 2

CityState

Postal / Zip Code
Business Type:
Tax Exempt? (If so, give numbers):
Corporation: blanks LLC:blank
Partnership: blanks Proprietorship:blank
Date Started:

MonthDayYear
Date
If incorporated, state in which incorporated:
Principal owners or stockholders:
Name, Title, and Address of Principle Owners or Stockholders: blanks blank
List any specific billing instructions below including need for Purchase Orders and extra copies of Invoices: blanks
Name, Address, Phone of Trade References: blanks blank
Name of Bank
Phone
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number: blanks
Federal ID Number:
The undersigned submits application for credit subject to the

following terms, and consideration for the extension of credit or the

establishment of an account, represents and / or agrees as follows:

1. All the information submitted in the application is true and correct to the best of knowledge, information and belief of the applicant. 2. The undersigned authorizes inquiry as to credit information and accordingly gives approval for those references to release credit information to Ironman Industrial, L.L.C. 3. If credit is extended, the undersigned personally and unconditionally guarantees payment for all invoices, services charges, and cost of collections. Additions or alterations to the contract are null and void unless approved in writing by an authorized representative of Ironman Industrial, L.L.C.
Damage Waiver
If approved charge customers accept the damage waiver, they shall pay (14%) of total amount shown in the rental column of invoice. If approved charge customers reject the damage waiver, they must furnish Ironman Industrial, L.L.C. with a certificate of insurance, or sign a written corporate responsibility agreement which states they have the necessary coverage and should a loss occur, equipment would be recovered.
Rental Rates
All rental rates are based on eight (8) hours daily, fifty-six (56) hours weekly, and two hundred twenty-four (224) monthly. All monthly billings are calculated and invoiced on a twenty-eight (28) day cycle. Overtime charges may occur. If further information on our damage waiver or rental rate policy should be required, please contact our office for more details explaining. Applicant’s signature attests financial responsibility, ability and willingness to pay our invoices in accordance with our terms of net 30 days from invoice date. Should it become necessary to place this account in collection, I / We agree to pay all collection costs and attorney fees. I / We agree that if partial payments are made or no payment is made on the account within the terms specified that you have the right to assets and I/we agree to pay a “finance charge” computed by applying a periodic monthly rate of 2% to the past due balance.
Company Name:
Date:

MonthDayYear
Date
Signature:

Clear
Title:
Printed Name:
Witness:
Should be Empty:

Damage Waiver

Rental Rates