Application for Credit

Company Information
Current Date*

MonthDayYear
Business Name*
Specific Type of Business
Business Address*

Street Address

Street Address Line 2

CityState

Zip Code
Is your Business Billing Address different from your Business Address?*

YesNo
Business Billing Address

Street Address

Street Address Line 2

CityState

Zip Code
Business Phone Number*
Please enter a valid phone number.
Business Fax Number
Please enter a valid fax number.
Email Address for Invoicing*
example@example.com
What is your Business Structure?*

Sole ProprietorshipPartnershipCorporation or LLCSubsidiary of
Subsidiary of:
Date the Business Started

MonthDayYear
Ignore if you are a Corporation
If a Corporation: Please list the date of Incorporation

MonthDayYear
Ignore if not a Corporation
If a Corporation: Please list the State of Incorporation
Ignore if not a Corporation
Contractor License Number
State of Contractor License Number
Contractor License Number Date Issued
Resale Exemption Cert. State
The state where your Resale Exemption Cert resides
Sales Tax Number

Owners, Princicpal Partners', Officers

Names & Addresses
Full Name*
Title*
Address*
Would you like to add another person?*

YesNo
Full Name
Title
Address
Would you like to add another person?

YesNo
Full Name
Title
Address

Are there any limitations on who is authorized to charge?*

YesNo
Please specify
Are Purchase Orders Required?*

YesNo
Payment will be made from?*

This Office (previously listed)Other
Address of Payment Disbursment

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number of Payment Disbursement Office
Please enter a valid phone number.
What are your terms to your Clients/Customers?*
Amount of Credit Requested?*
Name of Bonding Company Generally Used:
Address of Bonding Company Generally Used:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number of Bonding Company Generally Used:

Bank Information
Name of Bank (Business Account)*
Branch of Bank (Business Account)
Account Number (Business Account)*
Address of Bank (Business Account)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Branch Contact Name (Business Account)
Would you like to add a Savings Account?*

YesNo
Name of Bank (Savings Account)
Branch of Bank (Savings Account)
Account Number (Savings Account)
Address of Bank (Savings Account)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Branch Contact Name (Savings Account)

Business Credit References
You must provide 3 references
Business Name*
Business Account Number
Business Address*

Street Address

Street Address Line 2

CityState

Zip Code
Business Phone Number*
Business Fax Number
Business Email*
example@example.com
Business Name*
Business Account Number
Business Address*

Street Address

Street Address Line 2

CityState

Zip Code
Business Phone Number*
Business Fax Number
Business Email*
example@example.com
Business Name*
Business Account Number
Business Address*

Street Address

Street Address Line 2

CityState

Zip Code
Business Phone Number*
Business Fax Number
Business Email*
example@example.com

Credit Policy Acknowledgement
Dear Potential Credit Customer,

As a potential credit customer, we are describing our credit policy to you so as to establish the events and considerations that create a mutually acceptable credit relationship.

Our normal credit terms are net 30. This is established policy for all customers. Our collection procedures begin internally at 45 days. Accounts may temporarily be placed on C.O.D. if older invoices remain unpaid. If your normal payment cycle is greater than 30 days, please contact Roxy Whitehair in our credit department to arrange for alternative credit/payment terms.

In the event that an invoice goes unpaid for 75 days and we are required to use alternative methods of collection, you the customer, agree to pay all collection expenses, including reasonable collection fees, attorney’s fees and any other fees incurred in the collection of payment on any invoice or bill.

As a common industry routine, we place preliminary lien notices on jobs in excess of $2,500. We also reserve the right to process a mechanic’s lien on any project we provide materials or services for.

If you have any questions, please feel free to call. Please sign and return the document to our offices.

Thank you for considering Phoenix Precast Products, Inc. for your landscape furnishing and architectural precast needs.

Sincerely,

Credit Department

By filling out the content below, you acknowlege that you have read and understand the Credit Policy Acknowlegement that is listed above.
Printed Name*
Business Name*
Signature*

Clear

Personal Guaranty
Creditor:
Phoenix Precast Products, Inc.
Debtor*
Your Company Name
Today's Date*

MonthDayYear
Date
I, Type all guarantors here* in making application for credit acknowledge the following:
GUARANTY: The undersigned (each a “Guarantor”) jointly, severally and in solido and unconditionally guarantees payment of and agrees to pay to the order of Phoenix Precast Products, Inc. (creditor) all amounts for purchases, including interest, fees, charges and other amounts at any time outstanding under this agreement or any extension, renewal or modification thereof. The obligations under this Guaranty are independent and each Guarantor (1) agrees that Creditor may proceed against one or more of the undersigned without proceeding against Debtor or another Guarantor, (2) agrees that Creditor may obtain credit reports and provide credit information to others regarding each Guarantor, (3) agrees to pay all expenses, including reasonable attorney’s fees that Creditor incurs in enforcing this Guaranty and (4) grants to Creditor a security interest in products from unpaid invoices. Each Guarantor acknowledges that the terms of this extension of credit, along with any renewal, amendment or modification thereof, will be provided only to Debtor and that it shall be the responsibility of each Guarantor to obtain a copy of such document(s). Each Guarantor acknowledges that Debtor has agreed to be bound by this document. Each Guarantor also agrees to the terms of Extension of Credit. Arizona Guarantor’s spouse must also sign for community property purposes.
How many guarantors are agreeing to this document listed above?*

12
Guarantor 1: Name*

First NameLast Name
Guarantor 1: SSN*
Guarantor 1: Today's Date*

MonthDayYear
Date
Guarantor 1: Signature*

Clear
Guarantor 2: Name

First NameLast Name
Guarantor 2: SSN
Guarantor 2: Today's Date

MonthDayYear
Date
Guarantor 2: Signature

Clear
Should be Empty:

Company Information

Owners, Princicpal Partners', Officers

Bank Information

Business Credit ReferencesYou must provide 3 references

Credit Policy Acknowledgement

Personal Guaranty

Business Credit References
You must provide 3 references