Property Account Credit Activation Form

Property Account Credit Activation Form
Date

MonthDayYear
Salesperson
Branch Location
Property Name
Number of Units
Managed Type
Address

Street Address

Street Address Line 2

CityState

Zip Code
Managers Name
Phone Number
Email
example@example.com
Billing Contact (A/P)
Phone Number
Email
example@example.com
Property Management Information
Property Management Company
Phone Number
Address

Street Address

Street Address Line 2

CityState

Zip Code
Owner Information
Legal Name or Entity that owns this Property
Address

Street Address

Street Address Line 2

CityState

Zip Code
Business Structure (check one)
Ordering and Billing Information
Purchase Order Required
Tax Status (**if tax exempt, a copy of the exemption is required)
Payment Method

Other
Send Invoices To (check all that apply)
Email address for billing purposes
can list more than one
If 3rd party please check one

Other
Upon the earlier of (a) the date indicated on this account activation form or (b) my (our) acceptance of services or goods from Impact Floors of Texas, LLC dba Impact Property Solutions, I hereby agree and represent as follows: (i) if I am delivering this account activation form on behalf of a company or other legal entity, I have the authority to bind such entity to the terms and conditions of this form, (ii) the information furnished on this form is true and correct in all respects, (iii) I (we) hereby deliver this form to Impact Property Solutions, including, without limitation, for the purpose of obtaining a credit account with Impact Property Solutions and Impact Property Solutions may rely on all information set forth herein, (iv) I am (we are) authorized to bind the applicable owner(s) of the property or properties to which the goods and services contemplated hereunder relate, including with respect to any and all purchases or orders for goods or services made from Impact Property Solutions related to such property or properties, (v) I (we) authorize any person having information related to the management company or the applicable owner(s) to release financial information as credit reports to Impact Property Solutions.
Date

MonthDayYear
Date
Title
Signature
Printed Name
I (we) further agree and acknowledge: (i) that all invoices shall be payable to Impact Property Solutions at 2325 E. Belt Line Road Suite 200, Carrollton, Texas 75006, net 30 days of the invoice date, payable by check or ACH unless otherwise agreed in writing by Impact Property Solutions, (ii) to pay interest at the lesser of (a) 18% per annum or (b) the maximum interest rate permitted by applicable law on all invoices not paid within 30 days of the invoice date, (iii) I (we) shall defend, indemnify, reimburse, and hold harmless Impact Property Solutions from any and all losses, damages, fees, costs and expenses, including reasonable attorneys’ fees (including without limitation), fee costs and expenses related to collection of amounts outstanding or the enforcement of the terms hereof, including issuing demand letters and filing mechanics liens); (iv) that the performance of this account activation form, and any dispute, claim, or legal action arising hereunder or in connection with the goods and services contemplated hereby, shall have its venue determined by the state or county courts with jurisdiction over the location where the goods and/or services were provided;(v) account activation will not be complete until I (we) have signed and delivered this account activation form, and (vi) I (we) have the authority to act as agent on behalf of the owner(s) of the property or properties to which the goods and services contemplated hereunder relate, including to bind such owner(s) to the terms and conditions hereof in all respects.
Date

MonthDayYear
Date
Title
Signature
Printed Name
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Property Account Credit Activation Form

Property Management Information

Owner Information

Ordering and Billing Information